We are not moving forward. We are not moving back. We are simply standing in the middle of the road…

Colin McGrath is an SDLP MLA for South Down 

The creation of the National Health Service on 5 July 1948 was the first time, anywhere in the world, that completely free healthcare was made available based on citizenship. It was and remains for many, a radical ideal. The Minister for Health in the UK’s Labour government at the time, Aneurin Bevan, aware that many people saw its inception as radical responded with typical post-war Labour zeal, “We know what happens to people who stay in the middle of the road. They get run over.”

We cannot afford to stay in the middle of the road when it comes to our health. Regardless of political affiliation, or constitutional position, each of us loves and cherishes our health service. The NHS is regarded throughout the world, along with the establishment of the European Union, as being among the greatest post-war achievements. To this day, we laud this service as being there for us when we need it most, safe in the knowledge that it will provide us with the right service, in right place and at the right time.

However, it begs the question; how do we treat a service we claim to love so much? Does government treat our NHS staff, who treat us with nothing but care, with at best indifference and at worst contempt? As we emerge from the shadow of the COVID-19 pandemic, in the North we face a broken health service with a diminished number of staff. Those that remain are worked to the bone, stressed to the hilt and underpaid, to add insult to injury.

Strategies, papers and plans that should have been implemented long ago to finesse the approach of the health service, remain lying on Stormont shelves; gathering dust; or are launched but do not have the financial backing or political will to gain any real traction. We know these papers’ names and we know what they were intended to do.

Because of this, targets are missed and people die while waiting for bureaucrats to get to work. The landscape is bleak, and change is needed now. The scope of the problem is so all-encompassing that it is difficult to know where to begin. There is no one size fits all solution of course, but we must begin somewhere. I suggest, we start with that first call.

One part of the service that is continually under pressure is the Ambulance Service. These heroes arrive first. Heroic because they are often called out to highly complex and changing environments. Heroic for putting themselves often in harms way. They turn up after the initial call and intervene to stabilise and bring the sickest to our hospitals. If we fail in this first intervention, then subsequent treatments may be rendered useless.

While we know that, regrettably, people often have to wait too long for an ambulance when they are in an emergency, what may be less well known is that some are waiting significantly longer than others. We see once again the urban/rural divide with rural residents waiting significantly longer than their urban counterparts do.

Within my own constituency of South Down, during 2021 a recent request for information has highlighted that the average Category A (most urgent/life threatening) wait time in Belfast (BT12) is 6 minutes. While in Newcastle (BT33), a Category A wait time is nearly 22 Minutes. For Category B calls, the Belfast response is 27 minutes, yet in Downpatrick (BT30) it is 47 minutes. Repeatedly people in rural towns, villages and communities are being left to wait longer for an ambulance response than those in urban areas.

Some might say that this is just the peril of living in the rural area. However, this excuse simply does not wash. The response times for sizeable towns such as Downpatrick and Newcastle are too long, and tragically, in the last year people have died while waiting for an ambulance.

The Ambulance Service has said that they need more money to implement the strategic review which would deliver change and a service fit for purpose. This review would deliver an additional 325 jobs for the service. This of course requires an Executive and a Minister that can deliver additional funding. The question everyone will be asking is how long will we wait for that. But there are actions that should be taken in the meantime. While these are not a substitute for a full solution, they may at least give some support to the system.

1. Tackle the waiting times for ambulances outside Emergency Departments – a quicker turnaround time would get existing crews back on the ground sooner. It absolutely beggars belief that we are not implementing and enhancing the HALO (Hospital Ambulance Liaison Officer) project where ambulance staff assist in busy EDs with the handover process.

2. Ensure ambulances that are returning to the rural areas are not diverted to urban areas to respond to calls. If they are required within urban centres, then alternative ambulances must be dispatched to the rural areas to wait on calls, rather than waiting until they are called.

3. We should encourage the enhanced rollout of first responders in all our communities and not just rural ones – increasingly they are the first on the scene. Again, such a move should not be regarded as a substitute for full reform but a short-term measure to help save lives.

In the final analysis, narrow arguments about party politics or protocols won’t make a blind bit of difference when you need an ambulance. Regardless, there is much that we could, and should be doing in the absence of an Executive. Unfortunately, our current Assembly arithmetic means getting anything done is difficult. As a direct result the future for the service continues to look bleak at best and broken beyond repair at worst.

For now, we are not moving forward. We are not moving back. We are simply standing in the middle of the road. As Mr Bevan would say, we know what happens to people who stay in the middle of the road…

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