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Time to Take the Big Decisions

14th June 2021
In 1987 a handful of members of The Undertones formed a new band called That Petrol Emotion, with American  vocalists Steve Mack. They released a handful of great albums but never hit the heights of their former band. Their biggest hit single was ‘Big Decision’ which features the line, ‘you’d rather sail the ocean, than make a big decision.’ That line has been in my head all throughout this last week when the local news has been dominated with the implosion of the DUP and the seemingly intractable problem of hospital waiting lists in Northern Ireland. 

As the waiting lists get longer and longer the demands for someone, anyone, to come up with ‘a plan’ get louder. But hang on a second, we have plans, we’re actually very good here at creating plans, its the taking of the big decisions where we fall down, in health and elsewhere. 

The difficulties faced by our health service are not new; they have been evolving for more than a decade to the point where one in four of the population has been on a waiting list for more than a year. Its a distressing situation, and even the Health Minister Robin Swann was forced to acknowledge that for many, the health service just isn’t working. 

Remember the old ad for the Blood Donation service, with The Spinners singing, ‘In My Liverpool Home’? They sang, ‘if you want a cathedral we’ve got one to spare…’ Well if you want a plan to address the problems in our Health Service, we have about half a dozen to spare. Why does it take Northern Ireland politicians and civil servants so long to make the big decisions? 

It was the new DUP leader Edwin Poots who commissioned the Compton Report called ‘Transforming Your Care’ in 2011, which was followed a mere 4 years later with ‘Systems Not Structures’ commissioned by Simon Hamilton. In 2016 then Health Minister Michelle O’Neill led the way on the Bengoa Report which was agreed by all parties when it was published. The leaders of the two main Assembly parties are both former Health Ministers who have recognised in their time, that action is needed, but here we are in 2021, and we have gone backwards not forwards. Suspension of the Assembly for 4 years of course didn’t help but even in that period, more could have been done to advance the recommendations of Bengoa. Of all the issues facing the health service the waiting lists is the most problematic and the most high profile, but we don’t need a plan to address waiting lists; we have one and its only 4 years old. In February 2017 Michelle O’Neill published a carefully thought out Elective Care Plan specifically to tackle waiting lists. So more plans are not needed, implementation is. 

All too often the political parties agree a plan of action, only for local interests to frustrate and halt their implementation. It’s not good enough.

The decision taking malaise goes well beyond the Health sector. Between statutory consultations, judicial reviews, Equality Impact Assessments any major piece of infrastructure in Northern Ireland can take years, sometimes even decades. The Casement Park saga rumbles on to this day. It was December 2014, well over 6 years ago that a judicial review knocked back the original planning decision. An indication that planning permission would be granted for the revised scheme came in October last year, even that was 8 months ago and there is not yet any sign of a sod being turned on the site. 

The commitment to a Medical University in Derry was part of the New Decade New Approach agreement upon which the restoration of the Assembly was based in January 2020. Who can really say the campus is any closer to becoming reality now, 18 months later, amid political wrangling and non commitment from the Executive? 

I worked in the Executive back in 1998 onwards, when the Assembly was first established following the Good Friday Agreement. One of the most commonly used phrases among the parties and the senior civil servants, all good people who wanted the best for this society, was ‘cross Departmental Working Group’ which usually was suggested when any single issue was big enough to involve more than one Stormont Department. Unfortunately the result was usually an endless series of meetings with officials and Minister’s perhaps naturally retreating to the priorities of their own Departments, and decisions being kicked down the line. 

Many cities across Europe, including within our own shared islands, responded very quickly to Covid and the new normality of keeping our distance. In Cork and Dublin, Glasgow and London, decision were taken on pedestrianising significant parts of those cities. In Belfast we started well with for example enhanced bike lanes on the Dublin Road and the announcement that Hill Street would be closed to cars. Now, depressingly, there are petitions both for and against the Dublin Road cycle lanes and momentum seems to have stalled elsewhere. 

I know there are no quick fixes to our decision making processes but nor are there are acceptable reasons for decades long prevarication. 

There comes a time to draw a line under reviews, and make the big decisions. 

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