Speech by the Chairman of Northern Ireland Council
Dr Maurice Dunlop
Wednesday 3 July
Chairman, members of the Representative Body.
Northern Ireland Council has had an exciting and challenging year. Much change is afoot in medicine at present, some of it for unclear reasons.
Constructive innovation is welcome but upheaval for motives other than improvement of patient care needs very careful scrutiny.
New arrangements for General Practice in the aftermath of fundholding, abolished on 1 April this year in Northern Ireland, had appeared after a long gestation. Local Health and Social Care Groups (LHSCGs) are being established in a dictatorial way. The profession feels that it was denied an adequate and early input into the creation of these structures. There was insufficient consultation, possibly because decisions had already been taken and there was no intention of altering things in the light of representative medical opinion. Vague outlines and ambiguous guidelines appeared. Doctors are invited to serve on these groups with a lack of clarity about their working. The profession feels that the current position is unacceptable and is inviting practitioners not to join these groups as presently envisaged. Local Health and Social Care Groups are quite different to the Primary Care Trusts in England especially with regard to their control of the money to commission services. BMA Northern Ireland has welcomed the readily offered support of national BMA for local efforts to rectify this problem.
Increased funding for healthcare has been announced and although we welcomed this, we fear it is still not sufficient to make the improvements required. We have highlighted the problems in the media and raised them with politicians repeatedly. We have met with the Health Committee and written to all Members of the Legislative Assembly (MLAs) highlighting the profession’s frustration and concern about the continuing crisis within the health service and in particular the entire area of funding. We are concerned that Northern Ireland will not enjoy as large an increase in per capita spend as the rest of the UK because of the details of allocating Treasury funds to Northern Ireland.
A long awaited review of acute hospital services in Northern Ireland was commissioned by the Minister in August 2000 and the report containing some challenging and wide-ranging
recommendations was issued for public consultation in June 2001. We largely welcomed the recommendations whose chief thrust was rationalisation of hospital provision and made detailed comments on the report to the Department. We urged that a number of major decisions need to be taken now and that the review is progressed with as much haste as possible. As time went own we became seriously concerned about the timescale for implementation of the recommendations of this report. A further consultation period was finally initiated this June, which will last until the end of September while no improvement is made to the delivery of secondary care in Northern Ireland in the meantime. We are concerned that decisions will be too much influenced by strong local pressure to the detriment of an efficient province-wide service and have warned against this.
The government is undertaking a review of the public health function in the autumn and we are already actively preparing for this. There is concern that new administrative arrangements will impair service delivery.
The Northern Ireland Junior Doctors Committee has been extremely active in highlighting health service deficiencies and has raised the public profile of these problems enormously.
We, in Northern Ireland, are becoming increasingly concerned about the potential for nationally negotiated contractual agreements not to be simultaneously implemented in Northern Ireland. We have been promised the support of our colleagues in UK Council should this ever happen.
Northern Ireland doctors continue to be actively involved in national negotiations, in particular in recent months in respect of the new GP and consultants contracts.
On a more positive note, we are currently in the process of organising a second All Ireland Health Conference to take place in autumn 2003 and we hope that it will be as successful as the first one.
Finally, I should like to thank the staff of BMA Belfast office for their continued support and hard work during the year.
Chairman, I move.