New Decade, New Approach (NDNA),
a new Health Minister for Northern
Ireland (the UUP’s Robin Swann), a
renewed commitment to addressing
the plethora of problems within the
health and social care system in
Northern Ireland coupled with the
outworkings and implications of the
global pandemic in COVID-19 has
meant that this report on health policy
and its associated recommendations
could not be timelier. The issues facing
us do not need rehearsing again. We
know the challenges facing health and
social care. And as the Department
of Health has said, the solutions are
also challenging because ‘they require
sustained investment to address
backlogs and build our workforce, as
well as the radical reshaping of services’.
The funding provided in NDNA does not
appear to be enough already.
It is of course important to note that many of the
problems we face predated the collapse of the
power sharing institutions early 2017. They were
not simply caused by three years of a political
vacuum, albeit they were exacerbated by it. In
the absence of a Health Minister, questions were
asked about who was actually setting health policy
in Northern Ireland1. But there have been plenty
of health policy recommendations over the years,
so in many ways health policy had already been
set. As Birrell and Heenan point out in chapter
1, Northern Ireland has a long history of health
reviews and recommendations but implementation
has been problematic. The policy direction in
these reviews has been consistent, to shift service
provision away from hospitals and towards care in
the community, as close to home as possible.
We have taken this one step further. Drawing on
extensive expertise in the health and social care
system from across Ulster University, our report
Health, Equality and the Economy sets out what
we believe health policy in Northern Ireland
needs to focus on, beyond reducing waiting lists,
building a workforce and reshaping services away
from hospitals towards the community. From our
UU Economic Policy Centre perspective, Richard
Johnston points out in chapter 2, much of the focus
to date has been on healthcare spending, that
is, how much more do we need, on what do we
need to spend it specifically and over what term?
He rightly questions whether more funding will
solve the problems and argues that what we must
do as a society is to support the hard decisions that
increase efficiency, reduce waste and duplication
and encourage our citizens to become more
responsible users of healthcare services.
The issue of responsible citizenship in healthcare
is something that Marie Murphy picks up on
in chapter 7. While pointing out that physical
inactivity is the fourth leading cause of death
worldwide, she notes that Northern Ireland has
not had a standalone Physical Activity strategy
since the expiration of the Be Active Be Healthy
– The Northern Ireland Physical Activity Strategy
1996-2002. She argues that Northern Ireland
needs a policy now, one where physical activity
can and should be integrated into the environment
where people live, work, are educated and play
through a cohesive government-led policy with
joined up actions created and owned by multiple
stakeholders, including the public themselves.

Of course, greater efficiencies are made infinitely easier through the mainstreaming of healthcare innovations. As Jim McLaughlin notes in chapter 11, it is now obvious that we are entering into the age of Healthcare 4.0 with challenges that need to be urgently met. Key to these challenges is the upskilling and training of our workforce in the use of digital healthcare technologies. Efficiencies can also be accelerated through a more personalised approach to medicine. Tony Bjourson’s chapter 12 emphasises the need to incorporate genomic education as a core component in all clinical education pathways to drive more evidence-based diagnoses, treatments and medicines optimisation. 

And these are just a few examples. 

Our contributors could have said much, much more, but we’ve kept it brief for now. Policy briefs should be brief! 

Original languageEnglish
Number of pages41
Publication statusPublished (in print/issue) - 9 Dec 2020


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