The Bengoa reform is only the latest attempts to dismantle, rationalise and therefore privatise the NHS in Northern Ireland. The report – which has the agreement of all parties in the Executive – provides a blueprint for services to be withdrawn from rural areas and opens the path for ever greater encroachment by private operators in every aspect of health and social care.
The outworkings of this are to be seen in the growing role of the private agencies who are being paid hundreds of millions every year to deliver staffing – money that could easily fund a fair pay deal for NHS workers sufficient to bring back workers and end the staffing crisis.
But the staffing crisis that results undermines the delivery of services – most especially in rural areas where staffing retention and recruitment are most challenging – and this provides the grounds for Stormont decisions to cut services claiming that staffing levels are unsafe. Of course, those dependent on these fast-disappearing services find themselves forced to pay for alternative treatments – normalising the concept of paid medicine and undermining the ethos of the ‘free at the point of delivery’ NHS.
A few days after Christmas, I started getting calls for concerned parents and workers in relation to the neonatal unit at South West Acute Hospital. They reported that the neonatal unit had closed down.
I could hardly believe it but as I received more and more calls I started to fear that it was accurate.
Only four years ago, the Western Health and Social Care Trust had threatened to close the service as a cost-cutting measure. Our local campaign swung into action, we mobilised hundreds of local people twice in three days and threatened to take the campaign to Derry/L’Derry before the money to keep the service was magically found and the threat removed.
Conscious of this history, I submitted a question to the new Chief Executive of the WHSCT Neil Guckian on December 30th. I didn’t receive any response so I contacted local journalists about what I was hearing in both the Impartial Reporter and Fermanagh Herald. I suggested that if they would also ask the question we might get clarity. They both did so and we resolved to keep each other informed.
On January 7th I received a reply confirming my worse fears. The unit was down to two cots and these were only for assessment with babies being sent elsewhere. The unit was effectively mothballed. As expected, Covid was blamed although there was a recognition that this was a long-standing recruitment problem. This was certainly true.
In December 2018 and January 2019 NHS workers took historic strike action and won pay parity with healthcare workers in England and Wales as a result.
Now Healthcare workers are demanding a pay increase to recover all what was lost over the past decades.
Everyone needs to get behind those who have been on the frontline of Covid as they fight for a pay increase that will aid recruitment, end the staffing crisis and secure a proper standard of living for all those who provide vital health and social care.
A crisis has been building in the dental sector in Northern Ireland over many years but the Covid pandemic finally pushed it over the edge. Last week, the British Dental Association appeared before Stormont’s Health Committee to plead for action in the face of a grave threat hanging over the provision of dental services. Absolutely nothing was done until today when a last minute, u-turn was forced from Minister Robin Swann under mounting pressure from political representatives like myself and adverse media coverage.
Today’s decision means that none of the five Covid Emergency Dental Treatment Centres will close as planned next Monday; instead they will remain open until the end of August. It averts the immediate threat that dental services will be denied patients but the potential and even likelihood of a grave crisis remains high.
Aerosol generating procedures
Opened at the start of the Covid lockdown, emergency dental treatment centres provided access to what are known as ‘aerosol generating procedures’ (AGPs), which include such minor procedures such as drilling for fillings or even teeth cleansing. AGPs result liquid spraying in the air and particularly increase the rise of viral transmission. As a result practitioners and staff have to wear respirator units and higher grade PPE than are standard.
Dental practices which have reopened in recent weeks have not been allowed to conduct AGPs but they were set to take on this workload when the emergency dental treatment centres closed.
Unfortunately they were nowhere near a position to do so; the Health Department indicated several weeks ago that it was unable to obtain the higher grade PPE required by dentists to safely conduct AGPs. Each practice was left to individually source its own supplies. To add even more to the chaos, dentists were not even able to secure face-fitting to practitioners and staff members – required for the safe operation of PPEs – because of the small numbers of fitting specialists in the region and the huge demand for their services right now.
The result of these factors was that it will be many weeks – potentially months before most dentists will be able to safely drill or provide fillings – and that was assuming they could obtain the needed PPE once they were fitted. The BDA estimates that more than 90 percent of dentists in Northern Ireland will not have properly face-fitted PPE in place for Monday’s reopening.
It was always unavoidable that mistakes would be made during the handling of this pandemic. No public health threat on this scale has existed in any developed economy for many decades – and given that modern economies are integrated and interdependent (networked) on a scale previously unimaginable – the economic and social impact of a global pandemic were always going to pose severe difficulties. These unavoidable problems were always going to be exacerbated by the fact that governments globally are almost universally driven by the needs to facilitate the interests and the continued profits of the parasitic capitalist class – leaving working-class interests and safety a very low priority. But these considerations notwithstanding, it is also undeniable that there has been a range of governmental responses globally – leading to a varying severity of outcomes for workers in different countries and regions.
The Covid-19 pandemic came on the back of a decade of biting austerity cuts to public health and social care services in Northern Ireland. It also occurred against a backdrop where social care for vulnerable and the elderly was highly fragmented with the majority of residents in care homes being run by private companies ‘the independent sector’. Stormont parties on all sides had normalised the profit motive in the provision of care and indeed pump-primed the growth of the sector through public funding tied to the growing numbers of residents in private care homes. Nonetheless care homes operators often felt the need to ‘top up’ their public sector revenues through the imposition of hefty additional charges levelled on residents or their families.
The situation in care homes was always going to a major difficulty should a pandemic strike.