The Real Politick of Health

Michael McGimpsey has been one of the leading complainers regarding the recent PfG spending plans. He has requested (at least £300 million) extra funding with some significant backing.

This brought opprobrium from both Robinsons (Iris and Peter) at one stage resulting in Iris’s ejection from the chamber. Now, however, the SDLP seem to be asking the department to make efficiency savings. Efficiency savings, like anything else involving decisions may be unpopular with McGimpsey.
One of the many elephants in this particular room is the number of hospitals in Northern Ireland. The Hayes report (links no longer available) recommended reducing acute hospital numbers and a previous report to the old Stormont Parliament in 1966 recommended six acute hospitals (no online link).

A good parallel to draw is with Wales. Apart from along the M4 corridor; there are considerably fewer acute hospitals per capita frequently with larger distances between them and road links at least as problematic. Prior to the last Welsh assembly elections, Labour proposed merging hospitals and reducing their numbers. This proposal became an important issue in the election campaign there and following Labour’s poor showing these proposals were put on hold.

As medical practice moves inexorably towards increasing specialisation and larger individual units it is not just Wales where mergers and closures seen as medically and practically desirable then become politically unacceptable. Dr. Kieran Deeney’s two election victories in West Tyrone on a ticket of saving Omagh Hospital are paralleled in England by Dr. Richard Taylor’s victories in Kidderminster in another save our local hospital election. Even within the Westminster government itself there have been divisions with Hazel Blears being accused of hypocrisy for protesting against the closure of a maternity unit in her constituency.

Whilst an argument can be made for having as few as six hospitals in Northern Ireland; a good compromise would probably be to have the “Gold six”: Royal, City, Ulster, Craigavon, Antrim, Altnagelvin and a “Silver Three”: (my term) Enniskillen, Causeway, Newry. Clearly this would require the expansion of the remaining hospitals prior to the closure of the other units. However, the chances of persuading the politicians let alone the Northern Ireland population?

So the question is: Whatever the efficiency improvements and the medical arguments in favour of a rationalisation of the number of hospitals here; have hospital closures become politically impossible and to what extent do the medical and nursing professions support them?