JIM STEWART WAS REMOVED FROM THE NORTHERN TRUST BY EDWIN POOTS, AT THE TIME EDWIN POOTS VOWED TO FIX THE PERFORMANCE OF A&E'S, A YEAR LATER NOTHING HAS CHANGED DEPAITE A NEW BUILD A&E AT ANTRIM AREA HOSPITAL.
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JIM STEWART CBE
FORMER CHAIRMAN OF THE NORTHERN TRUST
It is almost a year since I was asked to resign by the Health Minister on the back of difficult performances in the accident and emergency department of Antrim Hospital. I have been watching with interest how the service has been performing since then.
I believe that the Minister wanted to make an example of someone in the Trust. His decision to remove me was unfair, unreasonable and without proper consideration.
Antrim Area Hospital had struggled since the Northern Trust was formed in 2006 to meet the A/E targets. This was due to insufficient resources in the hospital. It was more marked especially in the A/E department where nursing and consultant staff numbers were insufficient to meet the excessive demands on the service. Antrim hospital also suffered because of an insufficient bed capacity so that when there were peaks in demands patients could not be admitted within the twelve hour target. Understanding these issues is not rocket science. Unfortunately neither the Minister nor the Department wanted to hear these facts. Neither did the Minister engage with our Board to find out our views on the cause of the problem nor how it could be fixed. In the eighteen months that I was in post during Mr Poot’s regime he never met with me to discuss any of these issues. This was despite my written request to do so on behalf of the Board. The request was ignored.
The approach from the Minister was to issue a threat to the service. ‘Make the targets or heads will roll” and to the Chairs of the Trusts “hold the Executives to account or I will hold you to account”. This approach did not work and none of the Trusts made the targets. This threatening behaviour demotivated staff that is very committed to the health service. This was poor management practice and harassment and bullying in the extreme.
After almost one year since my removal there is still not a permanent Chairman appointed to the Trust. This is a reflection on how professional people in Northern Ireland feel about the treatment they receive when they are appointed to non-executive roles in health. The post has now been advertised for the second time.
I have no doubt that Mr Poots genuinely cares about the health of the population in Northern Ireland. However with a spend of over £4.6 Billion in an area that effects the life and wellbeing of everyone in the Province, NI deserves a Minister who possesses management skills and leadership qualities that will enable them to make measured and professional decisions in the best interests of ALL our population.
I would advocate the appointment of a Chief Executive of Health for Northern Ireland similar to the English model. This would ensure that the health service is less politicised. Hardly a week goes by that we do not have more controversy with regard to the services that are delivered never mind the pursuit of a political agenda in Northern Ireland. The debacle over the handling of care of the elderly has hardly given us any confidence in looking forward to old age. The current controversies over Adoption by Gay Couples, same sex marriage, and blood donation have dominated the news headlines for the past weeks. The inordinate amount of public money paid to the legal profession fighting a lost cause in the NI Courts on behalf of the Minister has rendered the decision making of the current Minister questionable.
Serious questions should also be asked of those who advise the Minister on these matters.
Effective leaders do not blame everyone else when things wrong. Leaders consult with all stakeholders particularly staff. Good Leaders motivate rather than threaten staff so than employees can excel in their job and feel valued.
The latest figures for accident and emergency waiting times are very worrying. This is at a time when they are normally much better. Despite a reduction in attendances of almost 7 % at the A/E departments the percentage of patients seen in four hours is actually lower than the same period last year. In fact there has been a steady decline in the A/E targets since 2008. Northern Ireland is now the worst performing region in the UK. This is an indictment on the Minister and Department of Health and despite a massive addition in funding, new A/E departments and additional staff. I repeatedly said that the resources were not sufficient to meet the needs especially in accident and emergency. The targets are fundamentally flawed from a management view because of the uncertainty of the number of patients that actually turn up needing treatment and when they do so.
With winter approaching and the inevitable surge in demands especially from our elderly population with winter falls, fractures, hypothermia and chest infections what can we look forward too? The population of NI can look forward to longer waiting times, congested waiting rooms and wards. What the people of NI do not want to see are more unexplained deaths, trolley waits, confused patients being left outside or moved in the cold alone and afraid as has been evidenced recently. That is reminiscent of a Third World Country not a Country that used to pride itself with the best heart surgery in the world, the best trauma teams in living memory and the highest expectation of orthopaedic patients in Europe. What has happened to the brilliant health service we all remember deserved and expected? The current sad but startling publicity surrounding the then unexplained deaths of little children as far back as 1995 have been eminently stated by Mr Justice John O’Hara. It would be a tragedy if due to poor leadership and shirking of one’s responsibility that such events should be allowed to occur again.
Mr Poots has staked his reputation on solving the A/E problem. He has failed miserably. In any other Region a failing Minister would by now have resigned. It is a fact of life in NI that Ministers do not normally resign even if they are publicly disgraced or are pushed to do so.