The plans for the Health Service contained in the draft Programme for Government reflect the lack of detail which characterises the document as a whole. While a sum of money for waiting lists has been mentioned no detail has been provided on whether this money will be used to build capacity within the Health Service to deal with waiting lists or if it is yet another gift to the private sector. There is no mention of funding to meet the pay rise for NHS staff within Northern Ireland, who once again find themselves the lowest paid staff across the UK. This not only flags up a lack of concern for those workers but shows the absence of any joined-up thinking in relation to poverty and the causes of poverty.

There is no mention within the proposals on how to do deal with the crisis in Home Care and the problems caused by the privatisation of domiciliary care services and the impact this has on discharging patients from hospital. Nor is there any mention of a serious intention to fund preventative measures in any substantial and sustainable plans to improve the health of our citizens.

The Health Service in Northern Ireland has over the past five decades been through several reorganizations. Billions of pounds have been squandered on new structures, each one having a detrimental effect on the delivery of much needed services. Much of what is wrong with the Health Service can be put right by taking a new direction. The Workers Party believes that what is needed is an open, transparent, and courageous debate on what type of Health Service is required to deliver quality outcomes and deal with decades of health inequalities.

That debate must challenge vested interests both inside and outside the Health and Social Care Service. The political parties in Northern Ireland in the past have agreed on many costly Health Service reorganizations that wasted billions of pounds and delivered nothing but privatization and fragmentation, resulting in outcomes that were detrimental to patients and service users, and millions of pounds being paid to private consultancy firms who were not interested in the best clinical outcomes, but a cost cutting exercise to balance the books.

Reducing health inequalities was one of their key performance indicators when the Assembly was established. Yet, despite many fine words and noble sentiments, health inequalities have not improved and the March 2024 report from the Northern Ireland Audit Office highlights the fact that not only have they not improved but have worsened over the past two decades.

All reports from experts in the field make the crucial point that social and economic issues must be addressed to improve health standards and deal with health inequalities. Health inequalities have several root causes - poverty, unemployment, low pay, and educational underachievement together with the lack of decent public housing all feature as key factors. The absence of a detailed plan specifying financial allocation indicates a lack of serious intent to improve health standards for our citizens or to tackle health inequalities for those living in areas of multiple deprivation.

The major crisis within our health service did not happen by accident, it happened by design. It happened because of decisions taken by previous Ministers and endorsed by the Executive and the political parties.

Privatization, fragmentation, bed closures, staff cuts, and reduced services, to balance the books on the backs of workers and the most vulnerable in our society, went unchallenged by those charged with scrutinizing all health proposals and decisions.

There is an obvious lack of a joined-up approach on the part of the Executive. It is the Executive’s responsibility to ensure that the appropriate infrastructure needed to facilitate positive changes and delivery of an improved standard of health care is in place. None of these proposed changes should take place without a full public consultation and a detailed Equality Impact Assessment on how these proposed changes would impact on working people, including those living within rural communities.

As pointed out elsewhere in this Response the Executive needs to urgently put in place the long promised Anti-Poverty Strategy. They need to legislate for a real living wage and proper terms and conditions of employment for all workers and commit to ensuring that affordable and free childcare places are made available now, and not at some future date. An immediate house building program needs to be scheduled to deal with poor living conditions and homelessness and allocated on objective need. Welfare benefits need to be changed to eliminate the two-child cap and winter fuel payments reinstated without means testing. These are the bare minimum and the first steps required to start the process of tackling health inequalities.

The Workers Party believes that only a socialist system of government can deliver for the working class. But in the meantime our Party will fight for the delivery of high standards of health and social care, and demand the State tackle the health inequalities that working class people have suffered for decades. The demand for a Bill of Rights advocated by the Workers Party which could increase the democratic rights of citizens and which was envisaged by the Good Friday Agreement has never been implemented like many of the other measures that may have improved the lives of citizens and the working class.