Department of Health making the most progress with decisions

Northern Ireland has now been without a functioning devolved government for 800 days. During this period, the Department of Health (DoH) has made the most headway with outstanding decisions.

Salary increases for health and social care (HSC) workers, to use one example, have emerged successfully from the deadlock. 

Last November, a formal offer was made to trade unions by applying NHS England’s pay settlement from 2018 to current compensation rates in Northern Ireland. This constitutes an estimated three per cent increase.

The following month, the DoH confirmed that it would be proceeding with the tabled proposals.

Speaking at the Northern Ireland Affairs Committee on 16 January 2019, Richard Pengelly – the Department’s Permanent Secretary – confirmed that the new sums should be reflected in pay packets for February, or March at the latest.

This development was made possible following the establishment of a Northern Ireland public sector pay policy by the Department of Finance.

Elsewhere, headway has been made within ‘on the ground services’ since late 2018. Hailed as “a new era in GP care in Northern Ireland”and a“key example of health and social care transformation,”multidisciplinary teams (MDTs) were piloted in Derry/Londonderry and County Down, swiftly followed by west Belfast. 

These teams see healthcare professionals, such as physiotherapists, placed in GP surgeries to resolve patient needs within the community and reduce pressures on hospitals by alleviating the need for further referral.

Crucially, the tentative roll-out of these MDTs is attributed to an alignment with the overall vision set out within ‘Health and Wellbeing 2026: Delivering Together’ – the high-level approach to transformation within the health service developed before the collapse of the Executive.

That said, other subjects are still awaiting ministerial action.

Prior to Stormont’s becoming dormant, the DoH provided core grant funding to 65 voluntary and community organisations. That scheme was set to be phased out by March 2018 and replaced by a new programme with an innovative component, designed during Michelle O’Neill’s tenure as Health Minister.

Since January 2017, the approval to continue operating the existing scheme, whilst simultaneously developing a fresh version, continues in abeyance.

In December 2016, now-retired Alliance MLA David Ford (a former Justice Minister) introduced a bill making provision “to decriminalise [the] medical termination of a pregnancy in those circumstances where the foetus is diagnosed with a fatal abnormality”.

The draft legislation progressed to the second stage of the necessary six, but any further progression is now contingent upon the return of the devolved institutions.

In the spring of 2018, the DoH, in partnership with the Department of Education, published a draft strategy for looked-after children. Work has begun on the consultation’s output report, but when this will be published is still unknown.

Whether the strategy will be implemented before an Executive is re-established will ultimately be at the discretion of the Permanent Secretaries for the Departments of Health and Education – Pengelly and Derek Baker, respectively.

The current oral health strategy, published in 2007, is just one of many in need of an overhaul. According to Director of the BDA Northern Ireland Tristen Kelso, the DoH needs to recognise the wider health benefits that can be achieved by prioritising oral health through “upstream intervention – on obesity, diabetes, cancer and beyond.”

Whilst the DoH has been comparatively proactive in its approach to making decisions while the Health Minister’s office sits unoccupied, evidently many issues are unresolved. In our next article of this series, the commissioning of a new Northern Ireland cancer strategy will be discussed.