Editorial: ​Still not talking honestly on health pressures

The NHS continues to be in crisis on both sides of the Irish Sea. At the very heart of it is political reticence.

​In England, a leading nurse has warned the UK government that it should “not to sail too close to the wind” when it comes to announcing a pay deal and hinted that the situation could escalate if the profession is left “underpaid”.

At its annual congress in Liverpool, Royal College of Nursing (RCN) general secretary and chief executive Professor Nicola Ranger will call on ministers to “stop the dither and delay”. She also warned that staffing levels are “dreadfully unsafe”.

In Northern Ireland, the deputy chair of the British Medical Association in NI has said that patients who cannot afford to pay for medical procedures upfront will suffer under a new reimbursement scheme. Dr Clodagh Corrigan was referring to the £215 million plan announced last week by Stormont’s health minister Mike Nesbitt to tackle hospital waiting lists. Patients waiting more than two years for an operation will be able to claim back money if they pay for a procedure in the Republic of Ireland.

Dr Corrigan told the BBC: "We know there is an enormous gap in health access and in poverty in Northern Ireland.”

We hear such criticisms yet on both sides of the Irish Sea there has been a political refusal to respond to very big problems. One is the massive increase in life expectancy (it is a miracle that people are living so much longer but causes huge pressure.

Another is the fact that our hospital systems are still too geared to the needs of a century ago.

Yet another is the huge pressure caused by mass immigration and the huge and sudden rise in the UK population.

A further problem is the vast cost of public sector pensions, enjoyed by doctors and nurses and others but designed for an age in which people only lived to three score years and ten.

We will not resolve any of these challenges if we don’t even discuss them.