The latest from Northern Ireland

Nuffield Trust highlights scale of Northern Ireland’s health crisis

Nigel Edwards, the Chief Executive of theNuffield trust, told the BBC this week that “heads would probably roll” in England if hospital waiting list figures were on the same scale as those currently seen in Northern Ireland. Mr Edwards said:

“These figures represent a very worrying situation in Northern Ireland. [They] compare very badly with the figures in England, where, if we saw this level of waiting, action would be taken. In fact, I suspect we would find Chief Executives being removed and urgent action being taken to bring in additional capacity to try and get the numbers down. Heads would probably roll in some cases for this level of waiting in some of England’s hospitals.”

Mr Edwards added that the Northern Ireland waiting list crisis requires immediate action, either within the health service or via the independent sector. He noted that, as elsewhere in the UK, Northern Ireland’s health service is struggling with finite resources and commented:

“Sometimes we have surgeons and nurses from outside the area and the reason why that’s been done in a number of countries is that the people who control the waiting lists tend to end up benefiting financially from all the private work that is then done. I think there is some sort of concern that there are perverse incentives for paying people large amounts of money because they have access to the waiting lists. The people who lead the system need to step up and take some bold decisions, both to clear the backlog and to deal with some of the structural issues and the shape of Northern Ireland’s health care system. And there are some big decisions that really need to be taken, decisions that have been ducked for nearly three decades.”

A DHSSPS spokesperson told the BBC that it is “disappointing” to see increases in the number of people waiting for treatment but added that the budget position “presents significant challenges” and that “work is ongoing on between the health trusts and the Health and Social Care Board to develop balanced financial plans for 2015-2016”. The spokesperson added: “Maintaining the safety of services for patients and clients will remain a priority”.

Unannounced hospital inspections to take place

The Regulation and Quality Improvement Authority [RQIA confirmed this week that it plans to carry out a new programme of unannounced hospital inspections across Northern Ireland. They will focus mainly on emergency care services. RQIA Chief Executive Glenn Houston said:

“Everyone has the right to expect a high quality of care when they are in hospital. To provide assurance to the public, over the next few weeks we will begin our new programme of unannounced inspections at acute hospitals across Northern Ireland. Our inspections will identify and report on what is working well, and where improvements are needed. They also underpin the DHSSPS’s Quality 2020 strategy, with a focus on increasing the quality of care and reducing harm to patients. During each unannounced inspection, our team will visit a number of specific clinical areas within the hospital. To help provide a clear view of the overall performance of each area inspected, we will inspect the hospital environment, observe practice, speak to patients, families and staff, and examine evidence including patient records, policies and other relevant documentation.”

£109 million spent on clinical negligence claims in Northern Ireland

Just over £109 million has been paid out in the resolution of clinical negligence cases and associated legal fees in Northern Ireland over a three year period, according to a BBC report this week. Between 2011 and 2014, the five HSC trusts settled a total of 570 cases. Around one-third of the total expenditure was reportedly incurred by the Belfast Health and Social Care Trust and, in more than one-third of all cases, the amount of money paid to lawyers exceeded the amount paid to the patient. Alphy Maginness of the HSC Business Services Organisation Directorate of Legal Service said:

“There can be very complex issues involved, particularly with these medical negligence actions. Liability is often not clear cut. There may be many arguments in response to liability. You have to understand that it is not just about lawyers. In these cases, we require the contributions of medical experts, forensic accountants, engineers, physiotherapists. Often they are not straightforward.”

Peter Walsh, Chief Executive of Action against Medical Accidents, said:

“The human cost of clinical negligence far outweighs the financial cost but millions could be saved if there were more honesty and earlier admissions of liability. It is when there are denials and delays that costs escalate. The absence of legal aid and necessity of no-win, no-fee litigation also increases costs.”

Rory McShane of the Law Society of Northern Ireland claimed that the complexity of many clinical negligence cases leads to high legal fees. He said:

“It is not the lawyers who are getting these monies and we should stop portraying it as such. There are a number of participants in bringing a successful case on behalf of a victim of a medical accident.”