Inquiry reports reinforce need for health and social CARE reform

Two major reports arising from separate public inquiries have once again brought the delivery of health and social care services in Northern Ireland into sharp focus.

Two weeks ago, Tom Kark KC published his inquiry report into the scandal at Muckamore Abbey Hospital, an institution for adults with autism and learning disabilities, run by the Belfast Health and Social Care Trust. The report was scathing and revealed many shortcomings in the care, protection, and oversight of some service users at Muckamore Abbey Hospital. Among its 106 recommendations, the call again, for a statutory duty of candour in Northern Ireland. Currently, NI remains the only region of the UK that has not legislated for this.

Last week, Christine Smith CBE KC published her report on the Urology Inquiry which revealed how systemic failures in governance, leadership and management in the Southern Health and Social Care Trust led to ‘serious harm’ for patients including failures in diagnosis, treatment and follow up.

Two inquiries, focusing on separate parts of the health and social care system, and in two different Trust areas, have drawn similar conclusions that highlight shortcomings in governance, leadership and management.

The reports follow years of sustained pressures on the health and social care system that are not slowing down. Northern Ireland is grappling with a myriad of issues including a massive funding gap, workforce challenges, waiting lists that are the UK’s worst, and pay disputes.

In the coming days, the Health Minister Mike Nesbitt will convene a summit of HSC leaders to discuss these reports and wider system reform. The focus is on prioritising patient safety in challenging conditions. As a Minister, he has taken a number of steps to drive forward reform in difficult conditions and has said he is keen to deliver on a vision that places a greater focus on neighbourhood care, delivered as close to home as possible.

As we move closer to the next Assembly election, the focus for an outgoing Executive and political parties will turn to what the next mandate will aspire to deliver and drive forward under a new Programme for Government. Health and social care, given the size of the block grant that is required to fund it, will be under the microscope. Piecemeal change needs replaced by strategic decisions that start to turn the tide.

Political parties are sharpening their campaign toolkits for an Assembly election in May 2027. They will want to see informed, evidence-based policy ideas that can help them deliver the shift-change in delivery of public services that we need to see. Organisations that can bring reasoned policy ideas, backed by data and evidence will fare best, but early engagement is key.