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

Dr George O’Neill on the slow death of general practice…

The 2004 GP contract was the result of significant problems in English inner cities with recruitment and retention of GPs. The continuity of care the bedrock of general practice was lost when GPs no longer were required with the implementation of the new contract to provide out of hours medical services. As a consequence patient care is now the responsibility of the Trusts for the majority of the time.  The loss of continuity of care means the GP is no … Read more

We need to play our part in saving the NHS by taking responsibility for our own health…

Criticising our over stretched health and social care service is less of a public pass-time than it was five years ago.    This is good and perhaps reflects a growing maturity as we begin to realise that these vital services, on which we all rely, can only do so much.   In the social contract – the basis of the 1948 Health Service Act – there were two sides; (1) government agrees to provide a health service free at the point of … Read more

If Medics Treated Patients As Governments Treat the NHS, We’d All Be Dead

Another Secretary of State pushes determinedly, blindly on with NHS reforms, with the notion they alone can solve the great mystery of health. No matter how well intentioned, policy making is doomed to fail as before. I humbly suggest another way. The NHS is now into its 30th year of perpetual reform (perhaps we should hold an anniversary party?). Yet it is still in need of reform. At what point do the politicians wake up and conclude that, in the way … Read more

Real politics prefers a health service Status Quo…

The media hype on our latest could-do-better Health Service report Systems not Structures:  Changing Health and Social Care, was more positive than I expected.  BBC wheeled out the usual pundits.  John Compton welcomed the report saying it was good to say things over and over again until the public finally heard the message.   Dr George O’Neill was unusually positive but that seems to be because his Accountable Care System (ACS) approach got a good airing.  At least George understands … Read more

The NHS prescription: £22 billion of efficiency savings

At what point can an organisation which has undergone many years of reorganisations and “efficiency savings” actually create any more efficiencies and still comply with the regulatory regime? Leave aside the arguments about the £350 million lie of the Leave campaign, because it’s not actually relevant until Brexit is complete.  Even if every penny we actually pay into the EU were diverted to the NHS, apart from the inability to fund agricultural subsidies and infrastructure funding, that is a long … Read more

It is time to take politics out of the day to day running of the health service. A guest post by Dr George O’Neill.

  All of the party leaders, before the recent election, committed themselves to taking politics out of health. Is that realistic? I would suggest not. But what we can do is we can take politics out of the day to day running of Health and Social Care. That is an entirely different prospect. Bevan’s original idea of the Health Service was that it would dramatically improve the health of the population. Demand would decrease and cost would be reduced. This … Read more