Ministers needed or universal free healthcare will be thing of the past

Opinion piece by Paula Bradshaw MLA (Alliance Party, Belfast South):

The news that the Department of Health would make arrangements to implement the recommended pay award for workers in the Health Sector was welcome, but the wholly unnecessary delay in putting in place a budget for it was just the tip of the iceberg. Health pay, budgets and transformation cannot be managed without Ministers in place urgently – and any party which really cared about our collective health and well-being would recognise this. 

The notion that we have a universal healthcare service free at point of access is already a delusion. Increasingly, people with means are understandably opting out of a system with vast waiting lists and collapsing primary care services, and choosing instead to pay to go private. This means we already, in practice, have a two-tier service – both for staff and patients. The founding principles of the NHS no longer have any meaningful application when that is the case. What needs to be done?

Firstly, any organisation is only as good as the workers within it, and if workers are not paid properly and do not have reasonable conditions, they will understandably begin to opt out. We need to reassess pay levels for full-time staff upwards in the light of the rising cost of living, and we also need to implement caps to stop agencies profiteering on the back of staffing shortfalls. This, of course, requires legislation – including a Minister and an Assembly. 

Secondly, we need to bring far more money into the Health Service while it is being reformed to enable “dual running” – i.e. the operation of the Service as currently alongside the reformed Service. This means a fundamental review of where we are allocating devolved funds – not least those wasted on segregated services or mismanaged programmes – as well as consideration of sources of other income. This too, realistically, requires Ministers and an Assembly. 

Thirdly, we need to implement the Bengoa proposals. This is an immense reform programme but it has the support of those working within the Service who recognise that it is the only way to restore a universal service free at point of access with expert, quality care available to the entire population on an equal basis. This will see more emphasis on the right pathway immediately upon entering the system, a greater focus on prevention and ongoing care in the home, and the development of world-class specialist provision. However, the programme requires significant legislative change – which again requires a Minister and an Assembly.

It is time for those who care about our healthcare to stand up and be counted. There is no excuse for not putting back into operation the devolved institutions of government to take responsibility for adequate pay, an enhanced budget and a vital reform programme.  


5 thoughts on “Ministers needed or universal free healthcare will be thing of the past

  1. As someone who worked for many years both in the health service and in politics I have come to two conclusions. There first is that the model on which the NHS is based (all care free at the point of delivery and paid in full by the public purse) is unsustainable as a way of providing a good health service, and secondly that no elected politician feels able to debate this issue in public, but rather all parties keep telling their electors that it is sustainable and deliverable if only more money can be given to health and social care, without explaining that this means less for every other sector, and that it is in any case undeliverable because there is an endless demand. It seems to me that his well-written article, which is mainly about the irresponsibility of some politicians who avoid devolution so that they do not have to make difficult decisions, does not address either of these two conclusions.

    • vote2016ni says:

      Are you inferring that there is a Machiavellian plan at work and, indirectly, the principal tribal parties wish for direct rule as neither want to be responsible for taking the hard decisions never mind debating them?

      • Not my article but for what it’s worth I don’t even think the big two parties really think about it. They thrive electorally on turning each other into the big bogey man, but that has nothing to do with the real issues they are supposed to be dealing with.

  2. Johnny Andrews says:

    But current institutions have failed. Need to reform Stormont and review GFA. Smaller parties need to step up to the plate and offer alternative

    • vote2016ni says:

      I would argue that the current institutions have not failed but rather the electorate has failed in voting back into government those with hidden agendas (sic).

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