Warning that Northern Ireland hospital beds could be cut may be partly bidding for money available in June, says former health chief

A former Northern Ireland health chief says warnings of an imminent "catastrophe" in the NHS here may be partly about jostling for extra money during this month's review of Stormont spending.

John Compton was speaking after Northern Ireland's six health trusts issued a statement on Monday, warning that hospital beds could be cut and care packages scaled back due to cutbacks.

The chairpersons warned of "catastrophic impacts" and said "intensive efforts" were being made to find significant savings for the current financial year.

But even with these, they said, a "very significant shortfall remains that could only be filled by measures with high and catastrophic impacts" the trust chiefs added.

Northern Ireland's six health trusts issued a statement on Monday, warning that hospital beds could be cut and care packages scaled back due to cutbacks. Photo: PA

New Health Minister Mike Nesbitt said funding cuts that cause “catastrophic impacts” will not be made on his watch.

But John Compton, a former chief executive of Northern Ireland's Health and Social Care Board, was not surprised by the news.

"The system has known for some considerable time that there's financial pressure," he told the News Letter.

A litany of previous reports on the way forward for NI's NHS have concluded that it must either radically reform or collapse, he said.

"Of course - all of the reports said that, even the Transforming Your Care report I was involved with in 2011. Everybody knew it."

To some extent the chickens have come home to roost.

"But also behind it all, there is the smell of a lot of politics going on behind it all, in the sense that they know that the June monitoring round is coming up and there's £200m available.

"So, you know, you could take a slightly cynical view that this is all about bidding for the June monitoring round."

Recommended NHS reforms from the Bengoa report in 2016 - and similar earlier reports - have not been properly implemented, he says.

There has been no political consensus among political parties about what is needed.

And over the last seven to eight years the assembly has been suspended for around five years - hampering its ability to make long term strategic decisions.

"The other thing about it is that in Northern Ireland we just simply cannot help from being parochial."

A politician once told him that if he was canvassing and admitted he supported the closure of a hospital, he would lose that vote.

"Everybody wants everything from the NHS round the corner from them."

But this is no longer possible because of the increasingly ultra-fine specialisation of consultants.

"You can't have hospitals everywhere, all doing the same exotic things, because you can't staff them properly.”

Highly specialised doctors will not go to work in rural hospitals where they get little practice and lose their skills, he said.

And the solution is not to increase NI's NHS spending from 51-52% of the block grant to 55-56%.

"Because then the impact on the rest of public services just becomes stronger."

Back in 2011 he spearheaded the Transforming Your Care plan which proposed shifting care from hospitals to the community where services would be better tailored to suit the individual.

In 2016 the Bengoa report gave a ten-year-plan in which all NHS services would have to meet criteria to prove they were viable.

Eddie Lynch, The Commissioner for Older People for Northern Ireland told the News Letter: “The Health and Social Care Trusts are right to draw the public's attention to the crisis in healthcare. This is a terrible outcome of the recent budget. Cutting care home beds and domiciliary care packages will seriously affect the lives of those concerned.

“At the least, the most vulnerable would have poorer health outcomes, increased levels of loneliness and isolation and these cuts would affect the quality of their lives. I welcome the Minister’s stance regarding the essential nature of these services.

“Choices will have to be made or resources found, but older and most vulnerable must not pay the price.”

Patient Client Care Chief Executive Meadhbha Monaghan told the News Letter that she noted the “stark and sobering message” from the health trusts about the potential impact current budgetary pressures will have on health and social care services and patients.

“Worry about cancellations, delays in treatment or potential changes to care packages will be extremely stressful and have an impact upon people’s mental wellbeing, as well as their physical health,” she said.

"This needs to be considered when members of the public are being communicated with. Whilst we recognise it is extremely difficult under the current circumstances, planning must be focused on maintaining the safety and dignity of patients. If people’s care is going to change or there will be reductions in outpatient care, they and their families need to be told at the earliest opportunity and supported through any change.

“It is critical that we stay in conversation with the public as the potential impact of these budgetary pressures unfold.”

“Our helpline, which provides advice and information to the public, is available Monday to Friday 9am – 4pm (or our email and online contact form is available 24 hours a day 7 days a week.) We encourage anyone that has concern about health or social care to get in touch.”

Click here to contact the Patient Client Care Council.