First published on Militant Left Website, November 27th 2022
Our health service is in a state of crisis. One after another emergency departments have had to close their doors to patients in recent weeks and months. Northern Ireland has the longest waiting lists in the National Health Service. It is not easy to make comparisons between European countries, but it is possible that we have the longest waiting lists in Europe.
In the last few days, the crisis reached a new peak for the people of Fermanagh and Tyrone when the South-West Acute Hospital (SWAH) stopped providing acute or emergency surgery and the biggest GP service in the county, Maple, which covers Lisnaskea, Maguiresbridge and Roslea announced it was handing its contract back. Now anyone who requires emergency surgery will have to travel for up to two and a half hours to Altnagelvin Hospital in Derry or to other hospitals including Sligo General.
The management of the Western Trust, which operates the SWAH, is blaming difficulties in recruiting new surgeons for the sudden end of emergency surgery. There is an element of truth in this claim but essentially, it is a smokescreen to hide the truth. If a hospital is pushed to the brink, its future openly questioned, its facilities under review, then the stopping of emergency surgery becomes a self-fulfilling prophecy. And once emergency surgery is withdrawn, then other services are called into question as acute hospitals are complex systems, in which different specialties rely upon others to provide a safe service.
Smoke and Mirrors
Smoke and mirror arguments are repeated elsewhere. We are told that there are too many acute hospitals in Northern Ireland and that the current hospital configuration is unsustainable. The Bengoa Report in 2016 recommended the closure of smaller hospitals alongside a raft of other changes. The dynamic is in one direction: increased centralization of hospital resources against the wishes of ordinary people.
In fact, the problems of our health service are long standing and are entirely driven by three factors: insufficient funding, especially over the last decade of austerity; a lack of long-term planning, in particular, a training plan for sufficient numbers of skilled staff; and an increasing reliance on private finance and the private sector, which drains funding from the NHS.
Some are blaming the crisis on the current absence of a functioning Executive and Assembly and argue that if a Health Minister was back in charge, things would change. The reality is of course, completely different. Over the last 10 years the Executive has operated for approximately 50% of the time and has been collapsed for 50% of the time. There is no discernible difference between when it operates or when it does not operate. The five main political parties-Sinn Fein, the Democratic Unionist Party, the Ulster Unionist Party, the SDLP and the Alliance Party-all been in the Executive over the last decade and are responsible for the problems that we face. If the Assembly and the Executive come back it will not solve any of our problems.
Support for December 2nd Rally Builds
The crisis across the health service has generated widespread concern and even fear. Health service staff are under immense pressure and after a decade of falling real pay are voting in one sector after another for industrial action. In the Fermanagh local communities are organising to defend the SWAH and building for a mass rally on December 2nd. To date one union, NIPSA, has declared in favour of industrial action to defend the SWAH.
We are at a turning point. A mobilised and united community has the power to save the SWAH. If the campaign is unsuccessful, it will go the way of the South Tyrone Hospital in Dungannon or Daisy Hill in Newry and will no longer operate as an acute hospital. And either health service staff stand together in industrial action, with the support of the wider population, and win a decent pay rise which reverses the losses of the last decade, or the haemorrhage of staff will continue. The future of our health service is a stake.
We Need a United Political Voice
We cannot reply on the five main parties but only the trade unions and organised and united community campaigns, including Fermanagh Save Our Services and the recently established umbrella group working to defend the SWAH, Save Our Acute Services. What is missing is a political expression of the class anger of ordinary people. The National Health Service belongs to the organised working class. It was created by the trade unions, the Labour Party in Britain, the Northern Ireland Labour Party, and active socialists and organised communities, over decades of struggle. The extension of the National Health Service to Northern Ireland was opposed by both the Unionist Party and the Nationalist Party. They only agreed under pressure and because they realised they had no choice. If they had stood in the way of the NHS for any longer, they would have reaped a whirlwind of opposition from ordinary people.
Over the decades since the 1940s ordinary people, organising through their trade unions and community campaigns, defended our health service from every threat. In 2022, the situation remains the same. Next year we will see local elections in May, and there may yet be an Assembly election at some point in the coming months. It is vital that in these elections the anger and the frustration of working people and young people is given a voice.
The issue of health has acted as a powerful spur to united political action in the past. The West Tyrone constituency elected a local GP to the Assembly, on a defence of the local hospital ticket, in both 2003 and 2007. When a hospital campaigner stood in the 2005 Westminster election in West Tyrone he gained a tremendous 27.4% of the vote against the opposition of the four main parties. In 2001, hospital worker and UNISON NEC member Raymond Blaney was elected to Down District Council after years of service defending the local hospitals through union and community activism.
Elect Proven Health Campaigners
The elections provide an opportunity for similar results everywhere. Cross-Community Labour Councillor Donal O’Cofaigh, one of the most prominent campaigners in defence of the SWAH, will be defending his council seat in Enniskillen in May. Other candidates may also stand including Caroline Wheeler who is at the forefront of the defence of carers and disabled persons rights both in Fermanagh and across the North and Cross-Community Labour Dungannon representative Gerry Cullen who is spearheading the campaign for an inquiry into nursing homes scandals. These are many other outstanding campaigners across the North who we need to elect to our council chambers and to the Assembly. Discussions should begin among hospital campaigners and trade unionists about endorsing genuine cross-community candidates who put the interests of working-class people first.