Is Northern Ireland a failed state?
I posted this message on Twitter (now X) this week due to my sheer frustration trying and failing to sort out my patients in the Bogside over the last few months.
It is clear that the NHS in Northern Ireland has failed. It is clear that the Northern Ireland state has failed in its most important duty, which is healthcare for the most vulnerable in our society.
The NHS should be a community resource where our tax pays for the service that we would choose to buy for ourselves as individuals.
The NHS on offer in NI is so bad we wouldn’t accept it for our pets not to mention our relatives.
It’s now close to impossible to work as a GP serving a deprived population who cannot afford to go privately.
GP appointments are hard to get, as services are underfunded and understaffed.
Ambulance waits can be longer than the life expectancy of the critically ill patient and when they do arrive, the patient often refuses to be taken to casualty because they know they would have to wait four or five days before a hospital bed is found.
Patients now choose to risk their lives and stay at home instead.
I can’t get my patients seen as outpatients as waiting times are the worst in Europe and I can’t admit patients to hospital or ED as services are overwhelmed.
I have more patients on morphine syringe drivers than I’ve ever seen in my 41 years as a doctor and there are now more formal admissions to psychiatric services than ever.
Dr Tom Black pictured at Abbey Medical Practice in Derry PICTURE: MARGARET MCLAUGHLIN
By every measure the NHS in Northern Ireland isn’t failing; it has already failed and no-one has a plan of how to fix it.
The NHS now masquerades in many areas as a pretend service that puts patients on waiting lists that are longer than the life expectancy of the patients.
Our politicians have failed us and I would now challenge them to step up and make the hard decisions needed, or please resign and get out of the way.
Our politicians have failed us and I would now challenge them to step up and make the hard decisions needed, or please resign and get out of the way
The reason for the NHS failing is simple. It is underfunded and as a result understaffed, as healthcare workers prefer to go to other countries where they’re treated better and they’re able to sort patients out properly.
The public become frustrated with the arguments and say things like Westminster needs to invest more, Stormont needs to make better decisions, doctors are paid too much, and GPs in particular need to work harder.
Staff as a result of being overworked and underpaid have become disillusioned and burnt-out and have chosen to work in Australia, New Zealand, Canada and the Republic of Ireland.
I’ve heard in the last week that the health service in the Republic is worse than Northern Ireland.
There’s no doubt that all health services have problems but waiting lists are much shorter for inpatient and outpatients and staffing levels are much better with better terms and conditions.
We are East Germany to their West Germany and it’s going to get worse, as they have a significant investment programme for staff and services through Sláintecare and we can expect to lose more doctors, nurses and other healthcare workers to the south.
So how do we solve this problem and fix our health service?
We need to increase funding either through taxation or charges.
We know that Westminster has no money and that Stormont won’t introduce local fundraising measures.
So we have to persuade our middle classes to pay more for some GP and hospital services.
We have to persuade our middle classes to pay more for some GP and hospital services (Anthony Devlin/PA)
They’re already doing this through private GPs and private hospitals. The problem is that this funding and staffing is lost to NHS practices and hospitals who cannot compete.
As a result we’re seeing staff moving abroad and moving to private providers and there aren’t staff available to work in NHS.
Politicians need to quickly find a way to allow GPs and hospitals here to develop alternate funding streams to recruit staff and deliver better services.
We also need to prioritise what the NHS does and stop doing some of the things we do at present, so that we can concentrate funding and staff on the most important areas such as paediatrics, geriatrics, maternity, cancer, emergencies and general practice.
Our politicians are involved in a collusion of anonymity, with the two major parties in particular, DUP and Sinn Féin, washing their hands of the problem, blaming Westminster funding or the inability of the Department of Health to manage services efficiently.
Hard decisions are needed.
There’s a very good example of how to run a better health service across the border with hybrid GP practices and funding.
Our health service cannot compete with Sláintecare and we either must adapt to compete or we need an all-island health service.
Seamus Heaney said that there was no such thing as an innocent bystander.
Our politicians are up to their necks in guilt for this mess in the NHS due to their failure to take the decisions and actions needed.
:: Dr Tom Black has been a GP in Derry for the last 36 years
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