Lisa Smith: The public expects the worst from the health service – we need to stop accepting excuses

It’s hard not to sound like a broken record when it comes to the need to transform the health service in Northern Ireland.

Of course, while I was writing about health, it was clear that the status quo just didn’t work.

This is very easy to illustrate by looking at the waiting lists in hospitals.

Over the past decade, the number of people waiting for their first outpatient appointment has grown from 103,007 to 358,807.

This statistic is nothing short of a scandal in itself, and yet the most recent startling waiting list statistic barely made it into the news, suggesting the public expects the worst.

What makes the current situation even more difficult to understand is the fact that for more years than I can remember, medical professionals and experts have been constantly ringing the bells warning that the National Health Service is headed for the abyss here.

Numerous reviews and reports were produced, all of which argued very eloquently that changes were needed.

Of course, proposals to close local hospitals were met with consternation.

And yet that’s not what it’s all about.

Currently, Northern Ireland simply does not have enough staff or hospital beds to keep up with the demand.

Health inequalities are widespread, more people are living with multiple comorbidities, the population is aging, and technologies and treatments are constantly improving, none of which is free.

It may not be popular, but we need to work smarter and improve the efficiency of the health service – not by closing buildings, but by changing how we use these buildings.

Health Minister Robin Swann boldly acknowledged today that the configuration of the health service in the future will be different.

What the proposals will be, we do not know, but it is likely that his announcement will cause irritation and raise fears that some services will be closed.

It goes without saying that although changes are absolutely necessary, they should not harm patients.

For example, it’s one thing to ask people to drive further for outpatient appointments – as long as it doesn’t negatively impact those who don’t drive or own a car.

It’s quite another thing to expect people who already live more than an hour from a hospital to have to make an even longer frantic journey through rural roads to get emergency care.

And this highlights the fact that transformation is not a simple or instant solution – it will involve inter-agency cooperation, even problems such as public transport and the deplorable state of some roads will have to be addressed.

However, if we are to secure the future of our National Health Service and the fundamental principle that health care should be free at the time of care, we will have to make difficult choices.

Mr Swann said public consultations on the plan would begin in October. — but, unfortunately, it is difficult to be inspired.

By the time the public sees the proposals, it will have been six years since the publication of the most recent major review of the Northern Ireland health service.

Over the years, the health service and patients have suffered untold damage.

Also, what is the time frame between consultation and implementation?

After all, public discussion on the future of stroke services in Northern Ireland ended almost three years ago and is still gathering dust on the shelves at the Department of Health.

Will this consultation experience the same lack of momentum?

We may also see a new Minister of Health appointed in the coming months and who knows if they will show the same political will to implement the change agenda as Mr Swann?

Who said that his successor will not announce another examination?

Lack of funding, political instability, Covid-19, lack of political courage to make difficult decisions – there were many reasons why there were no thoughtful and rational proposals in the past.

However, it is time for society to stop accepting excuses and start expecting the best.