Altnagelvin goes ahead, but at what price?

Health Minister Edwin Poots said on Monday:

Making a decision on the proposed radiotherapy unit at Altnagelvin was my first priority as Health Minister. It was vital that I took the time to look at all the evidence properly to reach the right decision for the right reasons. I have now thoroughly reviewed all the relevant information and I have decided to make the necessary funding – both current and capital – available. This amounts to £56million being made available to build the unit and an estimated additional £9million being made available over current service provision for running costs.

While not mentioned in his statement in the Assembly, in media interviews afterwards, Edwin Poots spoke of how he had been moved (perhaps swayed) by the evidence of cancer patients he had met and their experiences of travelling up and down from the north west for treatment.

While the Irish government is contributing €19m, it is not clear from the minister’s statement where the rest of the money is coming from. Money doesn’t grow on trees.

Unless Sammy Wilson won a rollover lottery as well as a seat in East Antrim, the NI Executive’s finances are no less stretched in May than they were in April.

What has been missing in all the coverage of this inevitable and widely welcomed decision is a discussion about where the savings can be found. The Belfast Telegraph explained:

Questioned by Assembly Members, Mr Poots also gave an assurance that other parts of the health service will not be affected by his green light — just seven weeks after his predecessor, Ulster Unionist Michael McGimpsey, warned he did not have the money to staff and equip the centre.

Fewer expensive cancer drugs? Delaying other hospital building projects? Fewer ambulance stations? Higher hospital parking charges? Fewer staff?

Something has to give. While the £40 or so million capital budget needed to build the unit may already have been earmarked by the previous minister, the annual running costs of £9m are unlikely to be covered just by a thorough reading of the McKinsey report and mere efficiency savings. Surely lots of other schemes and plans were already hoping to use that money, and something will have to give?

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  • Freyanne

    Thank you! I was beginning to think the media had gone completely soft on this. This is the only explanation that makes sense.

    Poots has to explain where the £9 million has been taken from and provide the detailed figures.

  • iluvni

    Does he?
    Whats going to happen if he doesnt?

  • ranger1640

    I would assume Poots is not going to be very popular in some parts of the country as he closes A&E departments and rationalises hospital provision around the country. To deliver the required savings to fund the running of the Altnagelvin regional cancer centre. In my opinion the rationalisation of NHS provision is long overdue.
    If I could give my personal view, they should co-locate the Beldoc, the out of hours GP service to an A&E in Belfast. On a recent visit to the Mater A&E with my daughter, it was obvious that the vast majority of those attending the A&E were not in need of A&E services, but needed a GP or Social worker.

  • Fair Deal

    Alan

    Part of the premis for your supposition is that McGimpsey was telling the truth. Something the Londonderry Sentinel FoIs on the issue would place a very significant question mark over.

    For example in the budget negotiations there was an increase in the capital monies made available to DoH to cover this project as well as an increase in revenues.

  • Fair Deal – Fair point.

  • Neil

    Sure wasn’t McGimpsey telling us the health service was damn near bankrupt while John Simpson was laughing at him for being so daft?

  • Cynic2

    It all depends on the assumptions you make.

    You can be very optimistic and promise to the hilt knowing that when the bills come in you wont be there to account for it.

  • ranger1640

    There’s a Beldoc on the other side of the road from the Mater A&E…

  • ranger1640

    Gonzo,

    I know it is however I feel it should be co-located with the A&E.

    As I said most of the people who attended the A&E looked as if they needed the services of a GP and social services rather than an A&E doctor.

  • aquifer

    How is he going to staff it?

  • joeCanuck

    I suspect he’ll be putting adverts in the newspapers and setting up interview panels. Maybe he might just have a walk-in clinic to be hired on the spot, though.

  • aquifer

    They have real problems staffing big hospitals outside of Belfast. Building them is the easy bit.

  • alex gray

    Sam Gardiner asked precisely this question in the Assembly on Monday. Poots slapped him down but Jim Allister later reminded Poots that he had not answered Gardiner’s question – what ws losin out so the cancer centre could be built?

  • As Alan correctly asks, what will be the price for the worthwhile creation of a cancer unit at Altnagelvin? The answer will be revealed in the fullness of time when one or two other projects are shelved, or one or two hospitals are shut.
    My solution is a restoration of prescription charges. Any right-thinking person (if such a creature exists) would concede that prescription charges are a necessary evil to help finance healthcare provision. It was an act of gross stupidity to reward us with a freebie. Nobody was on the streets screaming and shouting for free prescriptions, so this was a stupid giveaway by Michael McGimpsey. I propose £5 charges for full-time employed; £4 for part-time workers; with free prescriptions for under-18s, students in full-time education, the unemployed, and pensioners.
    Sorry to hijack the post by digressing on to prescription charges, but this is a long-winded answer to the original question. Perhaps prescription charges will be the price to pay. This is a least worse solution in comparison to ward closures.

  • FuturePhysicist

    In terms of the running costs,remember that of the £9 million spent, an additional £4.5 million will be added from ROI. That’s 1 pound or 1 euro in every 3 pound or euro spent here. The ROI pays for every third member staff, every third replacement radiotherapy machine should they break down, every third tank of cryogenic fluid, every third maintainance check, every third CT/MRI scan, every third of every third ampere of electricity, every third replacement part, every third broken window, every third mop the cleaning staff have to use to clean the place etc. So without this investment, the cut will be reduced significantly.

    Will money be saved in reducing expensive cancer saving drugs, perhaps, perhaps worthwhile if radiotherapy is the better option.

    In terms of staff, reducing staff numbers, well radiotherapy specialists wouldn’t be in low demand, they are a front line service that is understaffed, with ROI based staff added to the NI based ones the need to get overseas recruitment and older staff to stay on longer may be reduced. It’ll also reduces radioactive doses for the staff at large.

    In terms of building hospitals outside of Belfast, this is just political, research has been done that shows that the Derry location is the best option and that it will reduce the demands placed on City Hospital, it’ll save transport costs and demands made on staff.

  • FuturePhysicist

    Let’s not forget that decentralisation outside of Belfast was one of the key issues addressed by McKinsey.