The COVID-19 pandemic exacerbated the crisis in our local health service, but spiralling waiting lists, the cancellation of life-saving operations, and overworked, underpaid healthcare staff who were pushed to breaking point were a reality before the pandemic.
Stormont expects the public to foot the bill for its reckless culture of mismanagement and misspending. In late 2021, an official Health Department document revealed a wish-list of measures the Stormont Executive is aiming to introduce in the next Assembly, including patients paying for GP and A&E visits, and increased charges for prescriptions, domiciliary care charges, early years registration, and community care.
People Before Profit firmly believe that healthcare is a public service that must be free at the point of delivery, must be based on clinical need not ability to pay and must ensure health and social care staff are meaningfully respected and valued through fair pay and trade union recognition.
If elected, People Before Profit MLAs pledge:
Proper Pay for NHS Staff
Successive Health Ministers denied pay parity, proper pay, and safe staffing, forcing overstretched healthcare staff to take strike action in 2019 in order to improve patient safety and end unequal pay.
Robin Swann—with the support of all the Executive parties—has added insult to injury by awarding a below-inflation pay offer to the same staff this year, after their heroic pandemic efforts, that amounted to a pay cut in real terms.
Investing in the NHS must include investing in its staff. All NHS staff need a decent pay rise, especially as the cost of living soars. This will also make working in health and social care an attractive public service career. It will help fill vacancies and so reduce the waiting list backlog.
People Before Profit stood on pickets with health workers and supported their demands for fair pay. We would:
- Work with trade unions to amplify their demands at the Assembly level.
- Offer solidarity and practical support during pay negotiations including full support for strike action if the staff deem that necessary to remedy unequal and unfair pay, terms and conditions.
End Privatisation
For more than a decade, Health Ministers—from Sinn Féin, DUP, and UUP—have undermined the founding principles of the NHS by outsourcing services and staff recruitment to private operators. The Department of Health continues to spend hundreds of millions of pounds of public money every year on subsiding the private for-profit healthcare sector and paying recruitment agencies.
The Health Department handed over £27 million of public money to private healthcare providers throughout the COVID pandemic in exchange for taking private patients. It holds massive contracts with recruitment agencies that are ransacking the public health budget to the tune of over £280 million a year. That is an unfathomable £767,000 per day.
Outsourcing of care homes has been a disaster for residents and staff alike, leaving too many without proper care and preventing staff from giving such care. Social care in privately-run care homes has been plagued by complaints from residents and frontline staff – some so serious as to warrant policing probes and criminal investigations.
The COVID-19 pandemic brought these very serious issues to the fore. Families with disabled members found that the Direct Payments given to them as part of the “personalisation” agenda were useless during the pandemic but allowed the Health and Social Care Trusts to wash their hands of responsibility for their loved ones. Now many are discovering that they are recorded as receiving “Self Directed Support” (SDS) when, in fact, they are not directing the support they get at all.
The only people who gain are care homeowners who continue to see their profits soar. Runwood Homes, for example, raked in £20 million in profit while failing to meet basic safety standards at a number of its homes across Northern Ireland.
The outgoing Health Minister and the Stormont Executive talk of “tough decisions ahead” and that they plan “changes which will be politically challenging.” They are afraid to openly admit—especially before an Assembly election—that they plan to further privatise the health service. This is why private healthcare providers such as Kingsbridge Health Care Group ( KHG) have used bank loans to fund a £9 million expansion of their for-profit services.
People Before Profit have a radically different vision:
- Oppose and reverse privatisation within the NHS locally.
- Bring care homes back under NHS control ensuring that domiciliary carers would get the same pay, training, holiday, sick pay etc as Trust staff and that older or disabled people see an end to the 15-minute visits that are an insult to anyone needing care.
- Raise conditions for care home residents to NHS standards.
- Grant trade union membership and equal pay to all care home staff.
- End agency usage to save millions and ensure that all NHS staff are afforded permanent, protected contracts with full employment rights and equal pay.
- Bring private hospital care under the NHS control so that all medical resources and health resources are available to the public.
- Increased investment in general practice by 15% to alleviate pressure at local levels and expand the workforce, to help to reduce unsustainable workload
- Implement a multi-disciplinary team model at GP level to ensure equal and local access to mental health and social workers, physiotherapists, etc.
Tackle the Waiting List Crisis
Despite the same electoral promises we hear every election, the Executive have risked the public’s health year on year by cutting hospital beds. We have the worst waiting lists on this island, across all of the devolved administrations in the UK, and in the EU.
Almost 25% of us (more than 460,000 people) are waiting to see a consultant, waiting for surgery, or start hospital treatment. Half of the 350,000 people waiting for their first consultation appointment have been waiting for more than a year. Over 112,000 people are waiting for a first inpatient or day-case admission and around 184,000 people waiting more than a year for a first hospital outpatient appointment
Average waiting times for patients in need of a range of specialist services (such as urology, orthopaedics, pain management, general surgery, etc) is almost 6 years. Indeed, in the 12 months before the COVID-19 pandemic over 5,000 people died while on a health service waiting list in Northern Ireland.
Official Department of Health briefings shows the number of people on waiting lists will rise to 700,000 by March 2026.
People Before Profit consider this situation to be untenable and we would make reducing waiting lists a priority:
- Long term, multi-year investment.
- Push the British Home Office to grant the right to work permits to refugees and asylum seekers with professional backgrounds as doctors, nurses, surgeons, etc. so they can take up positions in the NHS.
A Proper Mental Health Strategy
The spend per head of population on mental healthcare is 27% lower here than it is in NHS England and 20% lower than in the Republic of Ireland, despite the needs here being higher given the impact of the Troubles.
There are huge differences locally in mental health outcomes between the most well-off and the least well-off areas (often where the Troubles hit hardest). People in the most deprived areas are more likely to die by suicide, just as they are more likely to die from heart disease or cancer. Job security, good incomes, affordable benchmarked housing, and increased welfare spending all help to reduce mental health problems, substance abuse, self-harm, and suicide.
More services are needed for early intervention, local counselling access, and loneliness, among others.
People Before Profit calls for:
- An immediate doubling of funding for mental health services to bring it, at least, in line with levels of funding for mental health services in Scotland, England and Wales.
- Long-term investment to restructure mental health services based on human rights and best international practice, and prioritising local community-based responses.
- Multi-annual core funding for services that currently depend on piecemeal funding.
- Increased access to early intervention services including family support hubs and via schools.
- A strategy on loneliness.
- Introduction of waiting time targets for counselling based on those put forward by the 123 GP campaign.
An All-Ireland NHS
COVID showed the dysfunctionality of operating two different health systems on either side of the border. A single all-Ireland NHS would benefit from economies of scale, allowing for savings in the long term. It would also help to solve the shortage of specialist doctors, nurses and other health care workers in border areas.
There is already a range of cross border health services, such as the North West Cancer Centre which serves Donegal as well as Derry, as well as the paediatric cardiac service which is based in Dublin for the whole island. The Stormont Executive has no problem relying on private healthcare services in the Republic of Ireland through the Reimbursement Scheme set out in the Cross-Border Healthcare Directive so there is no reason not to start the move towards an All-Ireland National Health and Social Care Service.
A COVID-19 public inquiry
Bereaved relatives and frontline care workers have called for a public inquiry into the Department for Health’s handling of the pandemic, particularly in care homes where almost 1,000 people lost their lives.
People Before Profit supports a public inquiry, including into the following:
- An assessment of the impact of austerity in the NHS and the outsourcing of residential and domiciliary care to private for-profit care homes. Hospital beds have been cut by 20% in Belfast and 10% across Northern Ireland over the past decade. This led to the discharging of potentially COVID-positive hospital patients into care homes so as to free up hospital beds.
- The financial resources that care homes had, specifically during the first wave of the pandemic, when there was a delay of PPE supplies to care home staff.
- The decisions taken to cancel life-saving surgeries and reduce urgent treatments and what impact this had on excess deaths since March 2020.
Oppose Bengoa Reforms
Stormont’s plans to ‘transform’ our health service—as outlined in the Bengoa Report—will result in the closure of local hospitals, the sell-off of services to private providers, and put private companies at the head of decision-making boards.
These ‘reforms’ are simply stepping stones to paving the way for breaking-up the NHS altogether.
People Before Profit believes that such regressive ‘transformation’ of this kind must be resisted.
- Investment led reorganisation toward a more preventative, community-based system; alongside local hospitals, statutory residential homes, etc.
- Regional specialisms alongside local hospitals – not instead of: local hospitals with A&E departments must remain open to deal with less severe medical emergencies.
- More ambulances and air ambulances to guarantee improved response times to medical emergencies and reduce transit times to local hospitals and regional centres.
- Recruit 100 more Cancer Nurses Specialists.
- A catch-up programme to implement HPV vaccination.
