Health service in Northern Ireland ‘facing unprecedented challenges and in need of radical overhaul’

The heads of the region’s health trusts delivered a stark briefing to Stormont’s new health committee, warning of unsustainable pressures on primary, emergency and social care and looming financial crises.

One trust chief executive said tough decisions needed to be taken, adding she had “never experienced anything like this before”.

Roisin Coulter, chief executive South Eastern Health and Social Care Trust, opened the session by praising healthcare staff for demonstrating “exceptional dedication, compassion, collaboration and creativity” over recent years.

She added: “Following the extraordinary efforts during the pandemic, our staff are now working in an environment where in nearly all areas the demand for health and social care services has grown exponentially far beyond current capacity.

“This is what is driving the increase in waiting lists in secondary care, the increase in the number of unmet domiciliary care packages in social care and the pressures being experienced by our GPs in primary care

“We must support our staff, they are the backbone of health and social care in Northern Ireland. The pay issues need resolved as a matter of urgency so that we can recruit and retain an adequate workforce.”

She said key issues facing the health service in Northern Ireland are increased demand, insufficient capacity, workforce pressures, resource availability and public expectations.

Ms Coulter added: “A radical overhaul is needed to address the crisis in health and social care, a credible long-term plan to rebuild and change.

“There are no quick fixes. What is needed will take years.”

She said health chiefs had been raising concerns for years about emergency care services facing “unprecedented challenges”.

She added: “It is resulting in dysfunctional emergency departments and, worst of all, increases risks to patients and results in poor patient experiences of the healthcare system.

“Most of my chief executive colleagues and myself have spent over 30 years working in health and social care in Northern Ireland and, genuinely, we have never experienced anything like this.

“It is not sustainable and decisions need to be taken to change this because we are not serving our population in the way they deserve.”

Jennifer Welsh, chief executive of the Northern Health and Social Care Trust, briefed MLAs on population challenges.

She said 17.2% of the population is now over the age of 65.

She added that healthcare is related to a number of social determinants, saying almost half of preventable deaths in Northern Ireland are attributable to deprivation

Neil Guckian, chief executive of the Western Health and Social Care Trust, spoke about finance.

He said a flat-cash budget for the coming financial year would leave all trusts with a roll-forward deficit of at least £50 million.

He added that trying to find that level of saving within his trust area would have “a devastating impact on services, access and waiting lists”.

Mr Guckian also said health service staff were leaving posts in Northern Ireland at “unprecedented levels”.

He added: “Trusts are losing staff to the Republic of Ireland as they offer significantly higher pay levels.”