It would be a tragic mistake to miss out (again) on any future expansion of health budgets

It’s best to treat Theresa May’s NHS/Brexit announcement with some scepticism, but perhaps not too much. It may well be what Robert Shrimsley calls “snake oil sloganising”, but an important political concession has been made. The NHS is running almost on empty, and needs a rebasing injection of funds. But it will also needs accompanying reforms. Not least in Northern Ireland, where we missed out on the Chancellor Brown years when funding ran relatively freely. Whether May ever delivers that … Read more

Happy Birthday NHS: What changes are necessary, and how might we make them?

Tonight’s Slugger event is highly focused on health policy, for which we make no apologies. One poor feature of devolution in Northern Ireland is its retreat from policy in favour of populism. However, this is also a wider feature of western democracy. About a year before the last but one UK general election, this animated conversation between Professor John Kay and Steve Richards illustrates the exact same casual (ie, uncosted) retreat taking place elsewhere: In Northern Ireland (as elsewhere), there … Read more

What’s happening to our health service?

Director of Communications for the health and social care system David Gordon shares his thoughts after six months in the job So where do you start when describing health and social care here? Serious problems are in the news almost every day. It would be wrong to ever downplay those problems. And yet they are not the full story. Great care is still being delivered by great staff every single day. The most recent Health Survey showed compliments from the … Read more

The spending dilemma in the NI Health Service

Nick Garbutt over on Scope NI has an excellent article on health spending and the challenges facing us in the future First to the budget. Secretary of State Karen Bradley’s written statement commits to a 5.5% uplift on last year’s allocation. This sounds terrific. But it is important to remember that the increase is based on last year’s starting position. However last year an extra £140 million was found for Health through in-year allocations – redistributing unspent monies from other … Read more

Professional Arrogance in Health Care: is it a systemic cultural problem?

“Shock”, “disappointment”, “disbelief”, “embarrassment” are just some of the many comments that accompanied the findings of Sir John O’Hara’s report;  The Inquiry into Hyponatraemia-related Deaths. The public, not only here but across the British Isles and beyond, have been made aware of unacceptable failings in the care of four (probably five) children and the cover ups to their avoidable deaths.  People are genuinely concerned and wondering how safe health care is overall.  This is a reasonable and rational reaction but … Read more

“Monolithic” NHS should back Northern Ireland Randox’s pioneering blood testing techniques

Randox  the global medical diagnostics company with principal research and manufacturing facilities in Crumlin Co Antrim, Dungloe Co Donegal, Bangalore, India and Washington DC has just been singled out for favourable mention by the Times science columnist Matt Ridley. He writes that its leading edge blood diagnostic techniques for cancer are not being adopted quickly enough by “a sclerotic NHS”. Randox was established in 1982 by its Managing Director, Dr Peter FitzGerald in Crumlin, and has since expanded globally. (see Wikipedia) … Read more

Join us for a free in conversation event: The drugs don’t work – our over medicated society…

In 2016 our population of 1.8 million received over 41 million prescription items costing over £400m. NI spends 40% more on drugs per head of population compared to England and 20% more than Scotland which is a region of comparable social deprivation.  Do we get 20% to 40% more value from our drug spend in terms of improvements in health and well being? Join us for a one on one discussion with myself (Brian O’Neill) and Terry Maguire. Dr Maguire owns and … Read more

Dealing with alcohol – how the ambulance service picks up the pieces…

We get the inside track from a serving paramedic… Given that we are now over the festive season but still very much in the grip of the annual winter pressures it was interesting to read the article by the Chief Executive of NHS England regarding drunk tanks (officially Alcohol Intoxication Management Services, Safe Havens or Alcohol Treatment Centres), as well as the associated social media reaction. Winter is traditionally a time when we see an increase in ambulance call-outs and hospital admissions … Read more

It’s time to bring back prescription charges for all – no exceptions…

  In a briefing document published on December 18th the Department of Finance outlined three proposed approaches to “balancing the budget” over the next two years.  For me, it was unsurprising that as part of the proposals to “raise additional revenue” for 2018-20, the department suggested reintroducing a charge for “each health service prescription item dispensed”. Prescriptions have been free here since 2010.  Reintroducing prescription charges could generate “up to £20 million” annually, the department estimated which I feel is … Read more

Homeopathy and the NHS…

So the NHS may finally be clearing its shelves of homeopathic practice and remedies.  To address the current funding crisis, the NHS has announced that a number of remedies which are either ineffective, frankly dangerous or both will no longer be available.  Homeopathy is one of them and rightly so.   No doubt some, perhaps Prince Charles a strong advocate for homeopathy, will protest that this move will adversely affect the health of the nation but they will be in the … Read more

What is the future of the NHS in the 21st century?

In his 1942 Report, Sir William Beveridge, a Liberal patrician, identified five ‘giant evils’ — Want, Ignorance, Squalor, Disease and Idleness. The Welfare State was founded in the immediate post-war period to improve the social conditions in the UK. The country was then bankrupt from war exertions; despite warnings, mainly from Conservatives, that the Welfare State was unaffordable, the Labour government, trusting in Maynard Keynes’ assertion that ‘we can afford whatever we want’ went ahead. The National Health Service was born … Read more

Don’t wait to wait for a human doctor? No problem just ask your local friendly vet to treat you…

The small market town I call home now has three! , three places where you can have piercings and tattoos applied to your body. It is apparently a thriving industry. I wondered if could diversify into this myself as I applied a ring to the nose of a young bull, I’m pretty sure there is a set of tattoo pliers in a drawer somewhere in the surgery from the days before microchips were used to identify greyhounds. It’s not as … Read more

Northern Ireland’s poor record on key health targets exposed in UK wide performance tracker

BBC News Online has launched a Health Tracker – usefully covering the whole UK for a change – to monitor targets in three key areas: accident and emergency departments, cancer care and planned operations and treatment. It will run for a year and you can keep checking on progress in your Trust area. While  they say it’s difficult exactly to compare like with like in the  four “ nations” because of policy differences on  choosing the  range of targets, Northern … Read more

Until we deal with the REAL reasons for our long hospital waiting lists we are just throwing good money after bad…

The problems in Northern Ireland’s health service (and in particular our constantly lengthening waiting lists) have been a recurrent topic on Slugger. Reference has been made to successive reports recommending transformation and hospital rationalization and the absence of any effective resulting action. As many of those reports have pointed out, the service here gets much more money per head than our adjacent jurisdiction England; we have more hospital beds, more doctors and more nurses. A 2014 study by the National … Read more

“Women in Northern Ireland continue to be discriminated against.”

With the Northern Ireland Department of Health refusing to update guidance to health professionals here regarding pregnancy terminations, despite the changes to UK policy announced earlier this year, in the Guardian Goretti Horgan, a lecturer in social policy at Ulster University and a founder member of Alliance for Choice in Northern Ireland, argues for change to address the equality issue that failed to make it into anyone’s ‘red lines’. [Because that would break the bastards? – Ed] Probably…  From the Guardian … Read more

What role do consultants play in health service waiting lists?

Seanin Graham’s exclusive in the Irish News “Desperate Patients Pay for Eastern Europe Ops” highlights a persistent problem in our Health Service; lengthening waiting lists.  She focuses on the use by local patients of surgical services in other European states and identifies the lengths some will go to improve their situation.   She has identified the problem and, for very few patients,  an expensive solution, and where this is a useful reminder that as a population we deserve better, she fails … Read more

People waiting less than a year in England for surgery compared to five years in Northern Ireland…

Great article by Seanín Graham in today’s Irish News about the ever expanding waiting list for medical operations in Northern Ireland. In Northern Ireland patients are waiting on average five years for routine operations. This compares to less than a year in England. From the article: It emerged that one million patients are now waiting in excess of 18 weeks for ‘routine’ operations in England. But in today’s Irish News, the story of a housebound pensioner who faces a five-year … Read more

Beyond a Spin of the Wheel – GPs and mental health care

The crisis facing GP services in Northern Ireland has been well documented, including in previous posts on Slugger O’Toole.  Increasing patient lists, ‘red tape’, underfunding, an ageing workforce and the compounding of health issues in deprived communities due to austerity policies, are only some of the problems faced by the service. The British Medical Association has mooted the unwelcome spectre of GPs walking away from the NHS, while the Royal College of GPs NI, in an open letter, has highlighted … Read more

Question for the NI Justice Minister…

Here’s something for an incoming Northern Ireland Justice Minister to grapple with…  It’s a question that arises following the UK Government’s decision to provide access for women from Northern Ireland to abortion services in England free on the NHS. From yesterday’s written answers in Parliament. Abortion: Northern Ireland Diana Johnson: [2513]To ask the Minister for Women and Equalities, with reference to her letter of 29 June 2017 on funding for abortions for Northern Irish women in England, what assessment she … Read more

The government’s idea of compelling doctors to work for a period in the NHS…

The general public regards the NHS as something between a ‘sacred cow’ and a ‘national treasure’, despite all the pressures that it is under. For decades it has provided a universal service, largely free* at the point of use. The public may have a collective memory of the abysmal provision before it was introduced; to see just what changes it made, you have to look for ‘the short and simple annals of the poor’ — you could start by reading … Read more