Yesterday’s visit by Professor Raphael Bengoa evoked a strong sense of déjà vu all over again. It is almost exactly eight years since Prof Bengoa and the expert panel he chaired set out a plan to overhaul our health and social care services amid firm evidence that urgent action was needed.
The problems faced by our health service today are largely the same as 2016, except even worse. The public is fully entitled to ask how a service which each of us and our loved ones depend upon from life to death has been so abjectly failed.
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The careful and structured transformation set out in the Bengoa blueprint has not happened. Where there has been change it has far too often happened as a result of chaos and collapse. Revisiting the 2016 report today, it is striking just how much of what should have happened by now has not. Reconfiguring hospital services is being talked about now, but should have happened years ago.
The problems faced by our health service today are largely the same as 2016, except even worse. The public is fully entitled to ask how a service which each of us and our loved ones depend upon from life to death has been so abjectly failed
A truism of Stormont politics - a mark of its immaturity, perhaps - is that MLAs will strenuously agree that ‘implementing Bengoa’ and addressing the health and social care maelstrom is their priority, only to change their minds when clinically-led proposals are made to, for example, change services in hospitals in their constituencies. Recent controversies around the South Western Acute Hospital in Enniskillen and Daisy Hill in Newry are textbook examples of this, though there are others.
This may in part point to a failure on the part of trusts in communicating the positive reasons for making certain changes but the larger failure is a political one. The Stormont Executive has singularly failed to make the decisions necessary to transform our health and social care.
They point to the Covid-19 pandemic as a reason for delay, though in fact it showed the health service’s capacity to change at pace, as well as the dedication of its staff. A larger blockage to reform was surely the five years wasted through Sinn Féin and DUP boycotts, though those parties are less keen to draw attention to that.
Addressing yesterday’s conference, Prof Bengoa, who clearly possess considerable patience and grace, gave a speech that could have been made in 2016. This included pointing out the need for a management system for change, plans and clarity and how tough decisions are needed around hospital expenditure.
“The leadership is there, there is a sense of direction and why not then take this moment to develop this for more rapid change,” he said, encouragingly. Whether the executive is really prepared to take the inevitably hard and unpopular decisions that change requires remains, as it has since 2016, to be seen.
