Transformation, Consultation, Election: Just what the doctor ordered?

With public services, and the NHS in particular set to feature in the general election campaign, Stratagem looks at what’s happening locally in advance of polling on 12 December.

In early October 2019, Permanent secretary to the Department of Health, Richard Pengelly, reminded us that the Department of Health must live within its means.

In a speech to the Healthcare Financial Management Association event, he stated that:

“Despite our well documented financial challenges, we are getting demands on an almost daily basis for additional spending. We simply don’t have the money to do everything we are being asked to do.”

Whilst money is lacking, consultations on the other hand, are not.

Consultations play an important role in the policy making process, enabling policy makers to harness the views of the general public, interested groups and other stakeholders on a particular proposal or subject.

A quick scan through the departmental websites will show that there has been a large number of consultations undertaken across all departments, with over 120 either having closed or are currently open in 2019 alone.  While the vast majority of these consultations have been on issues such as road traffic orders or the marketing of fresh horticulture products, it is within the Department of Health where we have seen significant consultations being undertaken in the absence of a Minister.

This has included public consultations on Reshaping Breast Assessment Services and Reshaping Stroke Services. These consultation processes have not been plain sailing however, and have encountered some issues along the way, including the cancelling and re-planning of public engagement events.

Both these consultations also had their deadlines extended.

The Department of Health is not the only Department to announce ‘big ticket’ consultations, with an Environmental Strategy Consultation due in the near future, by the Department for Agriculture, Environment and Rural Affairs.

On top of these consultations, there have been significant health announcements regarding a Suicide Strategy, a Cancer Strategy, a Cancer Drugs Fund policy drugs and the implementation of multi-disciplinary teams in GP practices. Not to mention access to the cystic fibrosis drugs, Orkambi and Symkevi, announced just last week.

All of these announcements would traditionally have been made by a Minister, but it is clear the Department of Health is chipping away at the Transformation Agenda whilst that position remains vacant.

Looking to Westminster, Sir Reg Empey has introduced a Private Member’s Bill to the House of Lords to divert Health powers to Westminster until an Assembly is restored, while this will now fall when Parliament dissolves on 6 November, it’s an interesting way of highlighting the impact of the local impasse.

A hot-off-the-press report by the Northern Ireland Affairs Committee into Health Funding has concluded that:

 "Transformation of Northern Ireland’s health and social care services in line with the aims and recommendations of Bengoa and Delivering Together is needed urgently if services are to keep pace with the increasingly complex and evolving needs of an aging population (pp.68)”

With an assembly election now postponed until at least January 2020, where will significant and necessary changes to the Northern Ireland health service be secured?

While a second DUP Confidence and Supply arrangement with the Conservatives is a possibility (but not necessarily a probability, but who can tell), on its own, it will not provide the necessary long-term investment the Northern Ireland health service needs.

Local party manifestos are set to be launched in the coming weeks, so how will health feature given the current political climate?