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Chris Toner, an emergency nurse at Northern Ireland’s largest hospital, loves her job. But as NHS staff strike for better pay and conditions this week, he admits he often hates his job.
“It never goes away. You’re constantly burnt out. You hate coming to work in the morning,” said Toner at the Royal Victoria Hospital (RVH) in Belfast, where the pressures that have sparked NHS strike action in England, Wales and Northern Ireland since Monday are at their strongest. .UK
In Northern Ireland, the National Health Service is seriously ill. The region spends half of its total budget on healthcare but has one of the longest waiting lists in the UK.
Pay for nurses in the region has not kept pace with the rest of the UK. In 2019 they staged their first strike in a century to achieve parity.
Their pay slipped back again this year because there was no regional assembly to sign off on a 4.5 percent pay rise as a political row over post-Brexit trading arrangements has paralyzed the region’s executive since May. Officials had approved the hike on December 8.
Ray Rafferty, trade union chair for the Belfast Trust which covers 13 health service unions, said it was “too little, too late”.
Even before the Covid-19 pandemic, the number of people waiting more than a year to see a consultant was 100 times higher than in England. More than half a million people – 30 percent of the population – are currently waiting for an appointment, admission or diagnostic tests.
Meanwhile, the number of GPs has been falling for years, driving more people into overcrowded hospitals where patients face an average wait before admission to A&E of 13 hours and 19 minutes, according to official data.
Claire Wilmont, 39, head nurse at RVH, regularly starts her shift in the emergency department with 60 to 80 patients crammed into beds or chairs with no space on the ward. “What we’re dealing with is a serious, ongoing, huge number of patients,” she said. “In 18 years [in the emergency department]I have never seen it so bad.
Toner, 31, doesn’t want to quit but said he understands what he does. “You can work at Starbucks and get paid the same,” he said. “With all the pressure [here]Does it matter?”
Gary Clarke, a paramedic with the Northern Ireland Ambulance Service, recalls being with a patient outside the hospital for 9½ hours this summer; Prior to that the patient had been waiting with other crew for seven hours.
“I’m not a big fan of strikes but I think in this current climate. . . After years of underpayment. . . If it is not [a rise of] 5 to 8 percent, don’t even worry.
But pay isn’t the only problem: Nurses say overcrowding compromises patient safety. Seven reports on Northern Ireland’s health service over the past 20 years have identified ways to improve the system.
One solution is to set up regional centers of excellence – but closing any hospital, even to deliver care more efficiently elsewhere, is fraught.
“Politicians are unlikely to close the hospital. . . for fear of losing crucial votes,” Ciaran O’Neill, a public health expert at Queen’s University in Belfast, and Dame Carol Propper, a professor of economics at Imperial College London, wrote in a recent study.
NHS hospital care costs in Northern Ireland have risen by around 28 per cent since 2016, three times the rate in England.
More than a third of those waiting for an outpatient appointment with a consultant have been waiting for at least two years. By March 2023, the target is 50 per cent to get an appointment within nine weeks and no one will wait more than a year but these targets look unattainable.
Brian Armstrong, director of unscheduled care at RVH – who, despite being a senior NHS manager, supports staff’s right to strike – admits the action will “have a bigger impact on waiting lists, of course it will”.
With weeks of strikes in various sectors across the UK, he said: “I’m worried [the government] Will be forced to hold the line. The NHS is vulnerable. We cannot allow the strike to go on much longer.
Private healthcare can offer a “safety valve” to counter this [waiting lists]According to Mark Regan, chief executive of Kingsbridge Private Hospital in Belfast. But he added: “I have always been in favor of health care that is free at the time of delivery. You can opt out if you want to go private, but you don’t have to go private.”
Regan said the number of surgeries performed by Kingsbridge, the region’s largest private hospital group, has nearly tripled in the past decade, and not just for the wealthy. The second largest number of patients came from West Belfast, one of the most socially and economically deprived areas in Northern Ireland.
Due to pressure NHS nurses may be attracted to the private sector by safer staff-to-patient ratios and in a sense they are valued; Other health professionals are looking to move abroad.
Mark O’Hare, a school vice-principal, said his brother, an accident and emergency consultant, had moved to Perth, Australia, and was “making double the money for half the work”.
While he supports the NHS, which he thanks for performing a double lung transplant on his wife, he takes out £20 a month private health insurance to cover being able to see a consultant every two weeks.
“There are waiting lists,” he said. “If you need it, it will be the cheapest £20 a month you’ll ever spend.”
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