Does the Executive have the will to make the tough decisions and face the consequences of real Health reform?

So after last year’s Donaldson report (saying clinicians should drive reforms and politicians take a back seat), we have this year’s Bengoa Report (commissioned by Simon Hamilton) along with the suggestion that the new SF Health Minister will do exactly that?

The report’s ten-year time span and lack of specific actions (costs would be both too great a fiction and scare too many skittish constituency horses to bear publication) gives report the minimum required verisimilitude.

Nolan has had great fun with the top priority this morning, which states “a short-term plan to tackle waiting lists to be drawn up by January” January is the next opportunity for the Minister to dip into the petty cash that may become available in the monitoring round.

According to Nolan, it appears that no such bid was received was forthcoming for the present monitoring round, and probably the last possible moment the Minister could realistically spend the money before the end of the year.

Leaving costs and lack of a bid for extra cash in spending rounds to one side, Rafael Bengoa is regarded as a world-wide expert in his field. It’s Donaldson with some practical outlines for what needs to happen.

None of it is news to anyone inside the NHS in Northern Ireland. Three major reports from 2001 until now have all recommended the same thing. The trouble is that no elected politician wants to be on watch when the big changes happen.

They can say what they like about clinician-led reform, their own voters are likely to take a very different view. Any politician anywhere near a decision to downgrade the new build Downe Hospital in Downpatrick faces huge agitation and most likely the chop.

Nigel Edwards head of the Nuffield Trust praised the Minister’s apparent willingness to step back from the management of health resources:

“It’s nice to see a minister with an appropriate sense of humility about their ability to do health care planning.”

In fact, this is a continuation of the DUP’s attempt to take politics out of health that I questioned the First Minister on in May…

The question hanging in the air is: do they have the nerve to press through, make the tough decisions and face the consequences to make it happen?

Mick is founding editor of Slugger. He has written papers on the impacts of the Internet on politics and the wider media and is a regular guest and speaking events across Ireland, the UK and Europe. Twitter: @MickFealty