Even a £150m cash injection would see NI's hospital crisis deepening

Setting out a grim future for health unless urgent steps are taken to implement long delayed radical reform of the entire NHS system in the Province, the sources said that in the following financial year

– 2019-2020 – even if between £265m and £340m extra money was found, the situation would continue to worsen.

Those comments more bluntly reflect the language of a briefing document from Stormont’s Department of Finance last month on what is likely to be next year’s budget, regardless of whether Stormont returns or not.

It warned that “the budget scenarios do not provide sufficient funding to maintain existing services”, with ‘health inflation’ of about 6% from an older population and more expensive treatments meaning that health requires increasingly vast sums of money just to stay where it is – and at its current position waiting times are increasing.

Facing a virulent strain of flu, an ageing population and a health system which has 10% fewer nurses than it needs and which too frequently cannot move patients out of hospital once they have been treated, many of Northern Ireland’s hospitals have taken the rare decision to cancel much elective surgery this month in an attempt to keep the doors of emergency departments open.

Chronic delays for elective surgery – everything from hip replacements to non-emergency cardiovascular surgery – are exacerbating problems in other parts of the system because people who should have been treated months or years ago find their symptoms becoming chronic, leading to the need for additional treatment.

Over the course of the last five years, the number of the most seriously ill patients attending emergency departments has soared by 78%.

There is significant support for many of the reforms – such as centralising some services in fewer but more specialised centres and treating more people outside hospitals – but others, which are likely to see some smaller hospitals either downgraded or closed, will be contentious in local areas.

Three weeks ago Sean McGovern from the Royal College of Emergency Medicine said “the situation is in crisis,” with “an extraordinary number of people waiting for a bed” and said that reform of the social care system was required.

The situation has been exacerbated by the collapse of devolution. Work on one key decision – on the criteria used to reconfigure services – has been completed by officials and has been sitting waiting for a minister for almost a year.