A political vacuum and a culture of centralisation are impeding reform of the health and care system in Northern Ireland, according to a report by the Nuffield Trust.
The think tank said a lack of political leadership is blocking progress and obstructing efforts to improve poor waiting times, on which Northern Ireland is already significantly the worst performer in the UK.
The report, which is based on interviews with health service leaders in Northern Ireland as well as outside experts and clinicians, reveals a patient in Northern Ireland is nearly 50 times as likely to be waiting over a year for care as a patient in Wales, which is the next worst performer.
It also argues that Northern Ireland is lagging behind on social care, despite being the only area of the UK with an integrated social care system. It is the only UK country to have not refined legislation underpinning social care in recent years.
The report also finds that historical failings in workforce planning for the health service in Northern Ireland are still prevalent, resulting in a shortage of important staff groups and a costly reliance on temporary workers.
Report co-author Professor Deirdre Heenan, senior associate of the Nuffield Trust, said the spiralling waiting lists in Northern Ireland represent a major breach of public trust in the NHS.
“Longer waiting times can be deeply distressing for patients and their families and make no economic sense,” she argued. “The equivalent of one person in five is on a waiting list in Northern Ireland, with more than 120,000 people waiting over a year for treatment. A citizen of Northern Ireland is more than 3,000 times as likely as a citizen of England to have been waiting more than a year for healthcare. How bad does it have to get before urgent action is taken?”
Mark Jones, vice chair of the Royal College of Surgeons of England’s (RCS) Northern Ireland Board, said although health and social care staff continue to work valiantly in the face of challenges, there are serious concerns over the growing gap between patient demand and the capacity of the health system to meet that demand in the current political environment.