EIGHT years after Professor Rafael Bengoa published his plan to reform health services in Northern Ireland, his name has become a byword for lost potential.
Since 2016, health reform has been blighted by five years of Stormont collapse (2017-20 and 2022-24) as well as the pandemic and funding crises.
As public services deteriorated, health workers and commentators have frequently vented about a lack of focus to fully implement the Bengoa reforms.
Read more: Health and social care reforms can’t be dodged any longer - The Irish News view
It’s easy to forget the report was the fourth major health review in Northern Ireland this century – the 2001 Maurice Hayes Review, 2011 Compton Report and 2014 Donaldson Review– all of them calling for less reliance on hospitals, centralising some specialist services and a focus on prevention and public health.
But in a statement before his keynote address at the La Mon Hotel on Wednesday, Professor Bengoa’s tone wasn’t one of disappointment, but rather ‘it’s not just you.’
“I am, of course, very aware of the challenges Northern Ireland’s health service has faced over the period since 2016,” he said.
“It is by no means unique in that regard. Right across Europe, there are major struggles on a number of fronts.
“These include balancing short-term pressures with long term reform needs, dealing with growing demand and greater patient complexity, and recovering from the impact of the Covid-19 pandemic.”
He added that the analysis in his Systems Not Structures report was “ever more pressing.”
After taking over as Health Minister during the summer, Mike Nesbitt has attempted to revive the momentum with his Bengoa reboot, ‘Hospitals – Creating a Network for Better Outcomes.’
Avoiding the vote-killer of hospital closures, the plan suggests using existing sites as part of a new network.
Hospitals would no longer be expected to provide every service and patients may have to travel further for treatment, but with less waiting times.
Welcoming Professor Bengoa on Wednesday, Mr Nesbitt added that his plan was not just about hospitals, but tackling health inequalities, rebalancing services to provide more community care and prevention rather than treatment.
These are now familiar promises for the devolution generation, but always with one obstacle after another standing in their way.
With Professor Bengoa renewing his encouragement on Wednesday, there at least seemed to be political consensus about the way forward.
Posing for photos with Executive colleagues and Professor Bengoa was Sinn Féin’s First Minister Michelle O’Neill, who was previously health minister in 2016.
Indicating the Executive was ready to back Mr Nesbitt in taking tough decisions, she said: “This is a collective effort. We need to work on this together. This is not going to fall, I believe, on the shoulder of one minister.
“I am the First Minister of the Executive and I’ll work with every other Executive colleague. I want us to fix our health service, I want us to invest in our workers, they’re the backbone that keeps the health service running.”
