When we look at previous health strategies, service changes and polices that the health service has been subjected to, what we are seeing today is no surprise. Since 1998 there have been 2 overall strategies, 1 created under Sinn Fein’s Barbrie De Brun in 1999 the other created under the DUP’s Edwin Poots in 2011.
This strategy was being implemented right up until 2010 when it was replaced by consultation process Transforming Your Care. Services that were lost as a result of this strategy include the total loss of acute services in Omagh, Mid Ulster, Whiteabbey, Dungannon, other services were also ear marked to downgrade such as Lagan Valley and Downe.
The new Hospital at Downe was built with the full understanding that it would not maintain 24 hour acute services as Developing Better Services was still being implemented.
This strategy was a direct attack on the capacity of acute, elective and non-elective care in Northern Ireland, and this strategy made it necessary for the government to have to go to the private sector to clear up long waiting lists.
Transforming Your Care is yet to be implement, led by John Compton, the CEO of the Health & Social Care board that overseen the worst performance in health in recorded history in Northern Ireland. While it does not reverse or give more acute services that were lost under Developing Better services it starts to focus on social care, with the marked closures of services for children, mental health and elderly. In most these services are being removed from the public sector and as there is still demand for services was still there tendered out to the private sector.
In between these 2 strategies we have also see the Comprehensive Spending Review in 2008 which was used to fast forward Developing Better Services. Special note should be taken that CSR 2008 was used to remove acute services from Mid Ulster hospital but it was the Equality Impact Assessment from Developing Better Services that the DHSSPS had to refer to prevent the Judicial Review going any further in the courts to save acute services in Mid Ulster. There was also the Review Of Public Administration in 2006 and Modernisation and Recovery in 2010/11.
What can be overwhelmingly seen from both strategies is that it reduced the capacity of the public NHS system to treat, care and deliver services for patients. In both cases it opened the door to allow the private sector to get it hooks in and begin and dictate terms and prices. An added blow to public services from some health staff was this move was welcomed as it meant more money and here is where we find another problem in our health service. In the past before these 2 strategies came into play we had a public health service that was capable of meeting demands, now we have a health service that can only function if someone is making a profit.
It is no use looking to our politicians to fix this problem, they created this problem, we have spent 16 years trusting political parties to do the right thing, and it’s obvious they will not. Yes they will protest and say it’s not fair but I have yet to see one put up a feasible argument against what is happening in health. In the case of Jim Stewart the former chair of the NHSCT, he was sacked by Edwin Poots for coming out with the very same concerns that Edwin is now coming out with, I think it is time for a very clear apology to Jim Stewart by the Health Minister.
Knowing that our political parties have failed us we now turn to senior civil servants to show us the way forward. During 2002 to 20007 we did not have a functional government in Northern Ireland, our services where overseen from London but in most dictated by civil servants and during this time period in respect to Mid Ulster Hospital and under the watch of Dr McBride the Mid Ulster was downgraded despite a risk assessment warning these civil servants not to do it.
We see John Compton’s attempt with Transforming Your Care (TYC), we also seen TYC bring in private business consultants like Pamela McCreedy from KPMG who later got promoted onto the Health & Social Care Board to oversee the flawed health strategy she tried to create.
Know we see civil servants and politicians have failed us and cannot be expected to put things right that leaves us with RQIA and the Patient Client Council. At a glance RQIA do investigate but are at the mercy of funding and being silenced by the Health Minister. The Patient Client Council is touted to be the patients watch dog however what exactly they do on a day to day basis other than promote Transforming Your Care and in several occasions stop public involvement in public debates is yet to be seen.
Politicians have failed, civil servants have failed, the watch dogs have failed, now who do we turn to? There is the BMA who if challenged anymore could see them putting GP services private like dentists and the GMC whom at the moment are under scrutiny for the way in which doctors are vetted and trained. There are also the trade unions but history has taught us in Northern Ireland they are ineffective and instead of challenging service changes sit in meetings and agree exit packages for staff.
Maybe its Tory cuts that are causing problems that were created here since before the current Tory government came into power in 2010, or maybe it’s the recession we are told we are not in anymore by politicians and their civil and private advisors.
We are letting senior civil servants and out political class sleep walk us into privatising our health system, they purposely damaged different areas within health so that they had to close, they purposely removed public services knowing that there was still a demand, they done this and we said nothing. In some areas where they shut hospitals of acute services all the political parties walked backed into power. To put that into context your ruling class shut acute lifesaving services in some areas that led to deaths and got re-elected with the promise to get them back.
The public are running out of options, the media is filled with sniping politicians and real balanced reporting is lost, if you look at Martin McGuiness’s first comments about health being more about the DUP leadership than the health issues at hand we are truly lost. Mike Nesbits first response was I told you so, SDLP came out blaming TYC which is not even implemented yet while the other parties stayed relatively quiet.
The last elections show us that the 2 major parties responsible for this mess, Sinn Fein & The DUP only represent between then 24% of those who can vote yet they control 100% of what happens, the public created this monster and to tame it will take the public getting rid of it.
Let’s take a case study look at this: If we take the Mid Ulster Hospital as an example, cited by Sinn Fein’s Strategy to be removed of acute services, after the CSR 2008 money had to be saved and services had to be closed. Whiteabbey was that cut, but because it was a political nightmare to shut it of acute services the CEO of the NHSCT Colm Donaghy was told in Sept 2009 to take both Mid Ulster and Whiteabbey but he was not allowed to make this public knowledge until after the MP election in 2010.
Take into account the loss of acute care in Mid Ulster the Trust lost; 160 acute inpatient beds, an A&E that had a capacity of 24,000 a year, High dependency beds, experience staff who retired, 5 different doctor training courses and this to begin with cost £40 million to do.
Antrim did not get the extra resources to cope with this so waiting list grew, A&E performance failed and experienced staff were replaced with locums. In the same year wards 2 and 3 closed in Mid Ulster this was cited as a one off saving of £800,000, this saving was wiped out by hiring out private beds in the private health centre across the road from Antrim Hospital. Crica 60 beds in the wards cost less that renting 15 beds in the private health centre.
I often wondered though how the private health care hospital got planning permission right beside a public hospital, maybe our politicians know something that we don’t.