Northern Ireland’s healthcare system is broken

Northern Ireland’s hospital inpatient waiting times are atrocious. According to the latest data released by the Department of Health, 41.3% of inpatient waiting times exceeded 52 weeks in the second quarter of 2019. There are no regions in England or Wales where the equivalent figure even exceeded 1% (I could not locate equivalent data for Scotland). By comparison, only 0.06% of inpatients in the Midlands of England waited over 52 weeks for admission to hospital; the probability of waiting over a year for hospital admission in Northern Ireland is 650 times higher.

The chart below shows the percentage of patients that experienced waiting times of less than six weeks by UK region since 2011. Ten years’ ago 55% of hospital inpatients experienced waiting times of less than six weeks; this year this figure had dropped to less than 10%.

A clear majority (64%) of patients in Northern Ireland experience waiting times in excess of six months.

There are significant regional differences amongst the various HSC trusts in Northern Ireland. The Western trust was the worst performer; 54% of waiting times for admitted inpatients exceeded one year. Of the 3,108 patients admitted for ENT surgery in the Western trust in Q2 2019, 59% had been waiting for over a year. By comparison, 41% of patients in West Lancashire in England waited less than six weeks.

There were significant numbers of patients waiting over a year for treatment in other areas, depending on the type of surgery. For example, 66% of ENT patients in Belfast had been waiting for over a year; in most areas on England there were zero patients who had to wait over 52 weeks for equivalent surgery.

The differences between waiting times in Northern Ireland compared with Great Britain are staggering. However, in terms of spending, spending on Northern Ireland is higher than the UK average. The chart below shows (inflation adjusted) per capita health spending in different regions in the UK.

Real-terms health spending has stagnated since 2010 as it has stagnated everywhere else in the UK. However, other UK regions have undergone equivalent conditions and have not undergone anything even remotely equivalent to the functional collapse of the healthcare system in Northern Ireland.

Whilst the continuing lack of a functioning executive means there is an accountability vacuum over the state of Northern Ireland’s health crisis, it is worth noting that the worst of the damage happened during the “jot and tittle” assembly between 2011 and 2016. Prior to 2011 inpatient and A&E waiting times were broadly the same as they were in Great Britain.

Given that Northern Ireland’s healthcare system receives the equivalent funding as the system in Great Britain, its present condition is, simply put, an absolute disgrace. The system is in dire need of urgent and drastic reform.