The health service provides one of the pillars on which a society stands. We all need healthcare at some stage of our lives. It is obvious to everyone that the health service in Northern Ireland is crumbling and unfortunately has become a reactive service capable of providing life-saving service exclusively under this pressure. A proactive service that provides preventative healthcare seems like a dream at this stage. Tragically, a fundamental pillar of society is crumbling, threatening to drag the country with it.
This is the very thing that public representatives are supposed to act to prevent. Yet here in Northern Ireland public representatives have gone out of their way to facilitate this crisis. Between identity politics and incompetence, Northern Ireland is without a meaningful democratic outlet. Nothing demonstrates this more than the DUP stance in regards to Brexit. Maybe some of our representatives are not worth their wages.
Given a 2019 report from the House of Commons NI affairs committee regarding health funding in NI it is hard to conclude that public representatives are unaware of the situation. However there is a disturbing line in the report. “Measures must be taken to prevent Northern Ireland’s health system from falling behind the rest of the United Kingdom and the needs of service users”. This would perhaps show that the scale of the problem is not appreciated, particularly that Gregory Campbell and Ian Paisley sat alongside former North Down MP Lady Silvia Hermon on the committee.
Conversely, former NI Health Minister Simon Hamilton demonstrated his awareness of the crisis by instigating a report scrutinising the health service. The report chaired by Professor Rafael Bengoa and titled “SYSTEMS, NOT STRUCTURES: CHANGING HEALTH & SOCIAL CARE” aimed to “produce a set of principles to underpin reconfiguration of health and social care services” and “clearly quantify the specific benefits in health outcomes that will be derived from the new model, both for individuals and the Northern Ireland population as a whole.” Essentially, the report aims to find out what’s wrong and suggest how best to fix it.
The report outlines the numerous problems facing the service such as an ageing population. Critically however, the report also outlines the impact social inequalities have on the service. How does a low-income impact diet choices? Does this increase the likelihood of obesity and thus the pressure on the health service? If a pensioner is admitted for a broken bone can she afford home-help? If not, they will occupy a bed unnecessarily. Additionally, the Bengoa report clearly demonstrates that administration staff are some the most numerous staff members of the NHS. Second only to nurses and midwives in fact who make-up 35% of the workforce while admin staff make-up 20%. If people, representatives included, believe that investment is the only thing that the health service needs are severely misinformed.
As the Bengoa report acknowledges that “we are currently papering over the cracks in the current system, rather than investing in long term strategic change”. To pull Northern Ireland back from the brink, we need leadership. We need our representatives to act in the best interest of everyone that calls Northern Ireland home. As Mary Lou McDonald announced Sinn Fein’s intentions to form part of the executive, the idea of a new politics retreated. The Sinn Fein president explained that Welsh language legislation had seen several iterations implying that this is only the first step in recognising the Irish identity through language. An indication of a return of identity politics that plagues Stormont. To give the House of Commons NI Affairs Committee full recognition, “ultimately, it will be up to Northern Ireland’s elected representatives to bring about the change the system requires”.