The cross-border health report they didn’t want you to see

As a former journalist, I do relish getting hold of a government report that makes eminently sensible recommendations but which politicians for some obscure reason do not want the public to see. So I was delighted when earlier this month a copy of the North-South Feasibility Study compiled by the Irish Department of Health and Children and the Northern Ireland Department of Health, Social Services and Public Safety came across my desk.

This was the report, completed 18 months ago, that was meant to ‘develop a strategic framework for taking forward on a North-South basis future collaborative work in health and social care, and in planning and delivering health and social care services, as may be appropriate.’ As its authors, a group of officials from the two Departments, the Health Service Executive and the Cooperation and Working Together (CAWT) cross-border health authorities network, say in its executive summary: ’Through working together to address major health issues, significant additional benefits to the population of each jurisdiction can be achieved, which could not be achieved by each system working in isolation’.

They then go on to outline 37 recommendations. There is nothing here that is even the remotest bit radical or undermining of existing institutions in the two jurisdictions. The report suggests that 10 of the recommendations should be taken forward as a priority because they ‘offer the opportunity for a more immediate impact on patient and client care.’

These are that the two Departments and the relevant agencies should promote joint programmes and approaches to tackle obesity, positive mental health and suicide prevention (with the present All-Island Action Plan on Suicide Prevention being broadened to include mental health promotion).

A collaborative cross-border model of care for patients with paediatric and congenital cardiac conditions should be developed.  Radiotherapy capacity in Altnagelvin Hospital in Derry should be planned and developed to improve access to radiotherapy for patients in the whole north-west.

The two Departments and their agencies should ‘explore the potential to develop, on a joint basis, a service for those organ transplants which are less common and which may require the critical mass of a combined population to be sustainable.’

The two Departments and their agencies should ‘evaluate the effectiveness of the current alert systems for children at risk’ and should ‘continue to take forward measures to improve child protection.’ They should work to ‘progress and formalise cross-border foster care arrangements to deliver services which better meet the needs of children in border areas.’

There should also be formal exchange of information on existing standards, types of homes, staff training and therapeutic support to children in need of protection to assist the North South Ministerial Council’s North-South Child Protection Sub-Group on Information Sharing.

‘Is that it?’ you might ask. Is there the slightest hint of a controversial line anywhere in these priority recommendations?  Gentle reader, you may be forgiven for thinking that this is the stuff of eminently practical, common sense, cross-border cooperation at its most mutually beneficial: working together to help children with obesity problems; bringing cancer patients from Donegal to nearby Derry for radiotherapy rather than to faraway Dublin; moving towards a more sustainable all-island organ transplant system; and exchanging information about child protection. The North South Ministerial Council certainly believes so, having reported progress towards a new radiotherapy centre at Altnagelvin, all-island paediatric surgery services, a new North-South child protection website and other issues listed in the report at recent meetings.

However the Northern Minister of Health, Michael McGimpsey clearly differs. This formerly most sensible of unionist politicians has repeatedly refused requests that he should publish this report. In his most recent statement on the issue to the Northern Ireland Assembly, on 17 May 2010, he said he did not see any opportunities in the report for ‘cooperation that delivers practical results and benefits for the population of Northern Ireland.’

The Minister said the report ‘does not explain costs or benefits; it asks for further research, consideration, investigation and so on.’ He told a Sinn Fein MLA, John O’Dowd, that he would have an opportunity to read the report ‘in due course. My problem is that I do not see anything in the report to implement. It is long on discussion and on the need for further discussion, but I am looking for practical steps.’ He said his budget was ‘smaller than is required to run the Health Service in Northern Ireland, and I do not have money left over for extras unless I am certain they will deliver benefits.’

John O’Dowd thought the reasons for non-publication of the report were ‘political rather than financial.’ Is this another example of an Ulster Unionist politician trying to ‘out-unionist’ the DUP on an uncontroversial North-South cooperation issue?

Andy Pollak

P.S. Further to my May ‘Note’ wondering whether the Republic of Ireland now had a better welfare state than Northern Ireland, I heard Father Peter McVerry, the Dublin priest who champions the cause of homeless young people, arguing on RTE radio recently that a promised increase of 200 social workers would hardly touch the huge backlog of young people, poor people and others seeking help with their multiple problems in the Republic. He said that if the South wanted to be on a par with provision in the North, 2,000 new social workers would have to be appointed. The Health Service Executive spokesman on the programme did not disagree. So if you are young, poor or otherwise particularly vulnerable, you’re probably still better off in the remnant of the British welfare state that is Northern Ireland.