Professor Rafael Bengoa – too many health services are based around buildings rather than being centred on what people and communities need…

Professor Rafael Bengoa the health reform specialist and the author of the Bengoa Report is back in town today to deliver a lecture at Queens. To mark his visit he has written the following article. I’m delighted to be back in Northern Ireland today, catching up with old friends and finding out at first-hand about the latest developments in health and social care. It is always an inspiration to see for myself the commitment and expertise of staff – and the …

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A Yes Vote is the Only Way to Legislate for FFA and Rape Cases

Ivana Bacik is leader of the Labour Party in the Senead. In a recent essay on this site, high-profile No campaigner John McGuirk wrote about the difficulties of having to make a Yes or No choice in the forthcoming referendum. While I disagree with how McGuirk represented the nature of that choice, with less than a fortnight to go until 25th May, he was certainly correct in saying that many voters remain undecided. Over recent weeks, I have been out canvassing …

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Nichola Mallon brings the sort of forensic scrutiny that’s vital to the future health of democracy.

Interesting to see that the Assembly’s absence produced an opportunity for an individual MLA to corner a particularly troubling issue that’s arisen in the Belfast Trust area. In this case, it was the SDLP’s North Belfast MLA and deputy leader, Nichola Mallon. It is too little understood, just how important this kind of visible inquiry into the conduct of public services (whether it be infrastructure or healthcare) matters to the health of democracy. Many issues (and I’m not just talking about …

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Direct Rule in action: “In the light of the ongoing absence of an Executive…”

Northern Ireland Assembly Legislative Consent Motions, required by the UK Parliament to legislate on devolved matters, may have been devalued by the absence of a protest by the then NI Assembly Speaker in March 2015, but the UK Government could at least pretend that one had been passed at that time.  Yesterday there was no such pretence by Steve Brine (Parliamentary Under-Secretary of State for Health).  Welcome to Direct Rule… My hon. Friend the Parliamentary Under-Secretary of State for Health (Lord O’Shaughnessy) …

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Next time, the governments must not leave it entirely to the DUP and Sinn Fein in secret

It would have been a remarkable feat if the DUP and Sinn Fein could have  struck a deal  in secret, alone and unaided.  Secrecy may be essential for last moves to reach a compromise. But over a year none of the ground had been prepared with the public and it showed. The background was too noisy – RHI, the sudden illness and death of McGuinness, minority governments in London and Dublin with other fish to fry, including monumentally,  the throwback …

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Professional Arrogance in Health Care: is it a systemic cultural problem?

“Shock”, “disappointment”, “disbelief”, “embarrassment” are just some of the many comments that accompanied the findings of Sir John O’Hara’s report;  The Inquiry into Hyponatraemia-related Deaths. The public, not only here but across the British Isles and beyond, have been made aware of unacceptable failings in the care of four (probably five) children and the cover ups to their avoidable deaths.  People are genuinely concerned and wondering how safe health care is overall.  This is a reasonable and rational reaction but …

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Archbishops and Admirals…

What do you suppose the following had in common: the American President Abraham Lincoln and his assassin, John Wilkes Booth, the German Emperor Frederick (Friedrich) III, the author of Household Management, Mrs Isabella Beeton, the impressionist painter Édouard Manet, the post-impressionist Henri de Toulouse-Lautrec, the gangster Al Capone, the composer Frederick Delius and the jazz pianist Scott Joplin, the Irish authors Oscar Wilde and James Joyce, the revolutionary Vladimir Lenin, the dictators Benito Mussolini and Idi Amin, the billionaire Howard …

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Donald Trump and the pathology of leadership…

Dame Iris Murdoch, the Dublin born novelist, won the Booker prize for fiction in 1978 for The Sea, The Sea. Her final novel, Jackson’s Dilemma, was published in 1995 and was met with a muted response from the critics. She was subsequently diagnosed with Alzheimer’s Disease which was confirmed on post-mortem after her death in 1999. Subsequently, a textual examination of The Sea, The Sea, Jackson’s Dilemma and her first novel, Under The Net, showed that her vocabulary was considerably reduced and ‘commonplace’ in her final novel, but extensive …

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Join us for a free in conversation event: The drugs don’t work – our over medicated society…

In 2016 our population of 1.8 million received over 41 million prescription items costing over £400m. NI spends 40% more on drugs per head of population compared to England and 20% more than Scotland which is a region of comparable social deprivation.  Do we get 20% to 40% more value from our drug spend in terms of improvements in health and well being? Join us for a one on one discussion with myself (Brian O’Neill) and Terry Maguire. Dr Maguire owns and …

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Dealing with alcohol – how the ambulance service picks up the pieces…

We get the inside track from a serving paramedic… Given that we are now over the festive season but still very much in the grip of the annual winter pressures it was interesting to read the article by the Chief Executive of NHS England regarding drunk tanks (officially Alcohol Intoxication Management Services, Safe Havens or Alcohol Treatment Centres), as well as the associated social media reaction. Winter is traditionally a time when we see an increase in ambulance call-outs and hospital admissions …

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It’s time to bring back prescription charges for all – no exceptions…

  In a briefing document published on December 18th the Department of Finance outlined three proposed approaches to “balancing the budget” over the next two years.  For me, it was unsurprising that as part of the proposals to “raise additional revenue” for 2018-20, the department suggested reintroducing a charge for “each health service prescription item dispensed”. Prescriptions have been free here since 2010.  Reintroducing prescription charges could generate “up to £20 million” annually, the department estimated which I feel is …

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Sleep; wake up to the benefits…

Sleep is finally revealing its secrets and they are proving more sensational than we ever dreamt. Sleep, that part of human functioning we treat with such contempt and distain, might be a means of improving many aspects of our lives particularly our health. Sleep, of sufficient quality and quantity, is offering a panacea for a range of medical conditions plaguing modern life. But will we listen? We; fail to take enough exercise, eat too much poor quality foods; sustain bodies …

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Bonfires and Traffic congestion; are we seeing the medical consequences?

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DoH’s Health Inequalities; Regional Report, 2016, just published, tells us positively that in general as a population we are in great shape. In spite of our national moaning about our poor health – and interminable complaining about the inadequacies of our health service – we are as a fact, on average, healthier than we ever have been with access to the most amazing services and procedures. We now live to 80; 100 year ago the average age of death in …

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What is the future of the NHS in the 21st century?

In his 1942 Report, Sir William Beveridge, a Liberal patrician, identified five ‘giant evils’ — Want, Ignorance, Squalor, Disease and Idleness. The Welfare State was founded in the immediate post-war period to improve the social conditions in the UK. The country was then bankrupt from war exertions; despite warnings, mainly from Conservatives, that the Welfare State was unaffordable, the Labour government, trusting in Maynard Keynes’ assertion that ‘we can afford whatever we want’ went ahead. The National Health Service was born …

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First part of the DUP deal funds goes to Health & Education

The Secretary of State has announced the first part of the DUP deal will go to Health & Education, the amount will come to £50 million. From the BBC The announcement was made as Mr Brokenshire brought a Northern Ireland budget before the House of Commons. The secretary of state told MPs that civil servants can decide how to spend the extra £50m earmarked for health and education. Here is the DUP Deputy Leader; Roll out of the first part …

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Prescription Medicines in the Dock – Who is to blame for the increasing drug deaths in our society?

Ireland bucks the UK trend in drug overdose deaths; here they are more likely to result from “prescription medicines” than “illegal drugs”. Coroners locally implicate; tramadol, oxycodone or fentanyl in overdose more frequently than in England, Scotland or Wales where deaths are mainly linked to; heroin or cocaine. One implication is that prescription medicines are more readily available and, extending this logic, doctors and pharmacists are in some way involved; if we did our jobs better drug deaths would be …

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Don’t wait to wait for a human doctor? No problem just ask your local friendly vet to treat you…

The small market town I call home now has three! , three places where you can have piercings and tattoos applied to your body. It is apparently a thriving industry. I wondered if could diversify into this myself as I applied a ring to the nose of a young bull, I’m pretty sure there is a set of tattoo pliers in a drawer somewhere in the surgery from the days before microchips were used to identify greyhounds. It’s not as …

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Demand for legal access to medical cannabis is pushing the debate ahead….

Pearse Donnelly, a musician, activist and medical cannabis patient. Regional co-Chair for United Patients Alliance here demonstrates how Cannabis debate is taking off even in politically becalmed Northern Ireland . Two decades in and almost forty weeks into Stormont’s mobocracy, cannabis becomes a unifying force between all major parties in Northern Ireland. All while our nomadic First and deputy First Ministers quibble at an ill-fated Conservative Conference. The representatives in support of this fresh controversy would surely that agree our …

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Don’t get bogged down trying to stay active, just go for a good walk…

Following a heart stent insertion and a chance meeting with an old friend I hadn’t seen for years – we were each at our GP surgery picking up heart medicines – we decided “walking for old men” would be our thing for 2017.  The medical evidence is clear; exercise is better medicine than our prescribed pills; we just needed the commitment. Sufficient exercise is more effective in reducing the risk of heart disease than taking blood pressure and cholesterol medicines; …

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The secret of surviving the cuts is easy – just don’t be poor…

It is fair to say that things are going to get worse. A friend in the civil service says they have been told to implement 4% cuts this year, 8% next year and 4% the year after. Education has a 105 million black hole. Health is getting 70 million chopped off its budget. And all this is before Brexit even happens which depending on your view shall either be calamitous or the making of us. My background is working class but …

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