Overwhelmed Health Service Broken, Lead Medic Says

Northern Ireland’s health care is broken and the hospital waiting list crisis is beyond repair, medical leaders warn.

In a tough interview, the head of the British Medical Association (BMA) in Northern Ireland gave his most damning assessment of the state of health services in the region.

Dr. Tom Black said the situation has become so serious that doctors now have an obligation to be open and frank with the public about their concerns.

“Northern Ireland’s NHS is down, that’s a big statement and we’ve never talked about it before, but we’re doing it today,” he said.

“As doctors, we have a professional responsibility not to scare people, but we also have a responsibility to be honest, which is why we have decided to speak up now.

“We have an obligation not to sit here and say that everything will be fine when it is not.

“The only thing that could be worse than no service is an imaginary service, and that’s what we have at the moment.

“At least when you tell people there are no services, they can go elsewhere, but when you pretend to provide a service, people keep thinking they will get the help they need.”

Among the many failures that threaten the safety of patients on a daily basis, which were noted by Dr. Black, are the following:

• Suicidal patients are cared for by family members at home due to lack of hospital beds.

• GPs struggle to get ambulances for patients with acute and potentially fatal illnesses.

• One hospital consultant is on call for 48 consecutive hours as the only doctor working in their specialty.

• Several GPs are getting ready to hand over contracts to health officials.

• Patients waiting for a cancer diagnosis for more than six months

• 15% of consultant vacancies in Northern Ireland are not filled.

Dr. Black continued: “We had a lot of discussions about why we think the health service is not working and it’s because the system is completely overwhelmed.

“Patients are not receiving services, the system is underfunded, there is not enough staff, there are not enough beds.

“The staff is under enormous pressure, the moral damage they endure is enormous, and by that I mean the anguish that the staff goes through because they see the harm being done to their patients and there is nothing they can do about it.

“I met with a committee of BMA consultants and asked them how we were going to fix waiting lists in hospitals and they said we couldn’t do that.

“To put it simply, there is no manpower to do it.

“The backlog is so big that we don’t believe there are enough doctors to do it, even using all the traditional queue measures.

“We know that hundreds of thousands of people are on waiting lists in hospitals, and even people with urgent and alarming referrals are not being accepted.

“Waiting lists are so long and service is so degraded that patients are harmed and some die as a result of the long wait they suffer.

“Doctors routinely ask their patients if they have health insurance when they refer them to outpatients, and health disparities will only get worse as those who can afford treatment move to private care.

“However, most of my patients cannot afford privacy.” Dr Black said in his general practice office in Londonderry that he does not know of a single patient who has recently had elective surgery without taking advantage of a cross-border health initiative.

The time-limited program was launched by Health Minister Robin Swann last June and allows Northern Ireland patients facing long delays in treatment to access private healthcare in the Republic.

Some or all of the costs are then reimbursed to the patient, but the scheme must be completed within a few weeks.

Dr Black continued: “There are huge disparities between the richest and the poorest in Northern Ireland and this situation will only get worse. When the system breaks down, people living in the most disadvantaged neighborhoods will suffer even more. For example, life expectancy for men living in the most disadvantaged areas in 2018-2020 was 74.5 years, while in the prosperous it was 81 years.

“Patients are currently waiting 12 years for a hip replacement, so that means if you are 62 years old and have been told you need a hip replacement, but you live in one of the most disadvantaged areas, you will die before you will have an operation. “.

Dr. Black also warned that GPs are struggling to keep up with demand as an increasing number of surgical departments prepare to drop their contracts, which could lead to collapse of services in some areas.

“When a clinic returns its contract and a replacement cannot be found, the patients of this operation are distributed to other clinics,” he explained.

“This creates an additional burden on the staff working in these clinics and makes it difficult for patients to book appointments.

“Eventually, staff in these operations burn out, which also threatens the closure of this practice.

“There is real concern about the domino effect of these impending closures.”

Dr Black continued: “Nothing we have ever done before will fix the NHS this time. We need to do something radically different, but it’s up to our democratically elected representatives to decide what it is.

“I’m sure we’ll be accused of entering political territory on this issue, but it’s clear that, in a duty of frankness, we must be honest with the public.” A Health Ministry spokeswoman said patients and staff in distress “need to be given hope” that the health service can be fixed. “Despite the deep-seated and well-documented challenges facing services, now is not the time to lose hope,” she said.

She said the minister has put forward a number of investment and reform-led waiting time initiatives, although Mr Swann has made it clear that budgetary and political pressures “are major hurdles.”

She continued, “However, the advice of despair is not the way forward. Although the pandemic has disrupted services and seriously exacerbated pre-existing problems, the situation can be corrected in time and with the collective will.”