THE crisis in the health service is normally described in terms of lengthy waiting lists, overcrowded emergency departments and the scaling down of some hospital services in Newry and Enniskillen. The solution to most of these challenges is usually identified as additional funding.
However, despite being allocated more money, health minister Mike Nesbitt claims his department is still under-resourced. While he is currently in negotiations with health unions to try to address their demand for salary increases, he now faces two additional and hitherto under-reported needs for extra funding.
The first comes from GPs. The chair of the British Medical Association’s NI General Practitioners Committee, Dr Frances O’Hagan, recently said that practices are at risk of closing unless funding issues are resolved.
She pointed out that as well as being denied the same pay uplift as in Britain, GP practices here are also facing additional costs “of tens of thousands of pounds” because of the hike in employers’ National Insurance contributions.
The second challenge facing Mike Nesbitt comes from community pharmacy. West Belfast pharmacist, Paul McDonagh, has told this newspaper that inadequate funding has meant that on some months he does not take home a salary.
For 30 years community pharmacists have been paid a dispensing fee of £1 per item, which rose to £1.16 this year. In that period, staff salaries have increased by about four times.
The result is that many pharmacies are now proposing to reduce their opening hours to cut costs. This comes at a time when pharmacists' roles are expanding to include advice and treatment of minor complaints, thereby relieving GPs of more routine tasks.
Few would disagree with the opinion that community pharmacists are the lifeblood of the NHS at a local level. They are an essential part of the health service and they must be adequately funded to continue with their vital public service.
Thus the Minister of Health must now recognise that there is more than one funding crisis facing the NHS.
Following his appointment, he said his immediate priority was the health and well-being of the people of Northern Ireland. Noble sentiments indeed, but it is difficult to see how that objective can be achieved without a fully funded GP and community pharmacist system.
These two professions manage the main entry points into the NHS. While the minister has focussed on a re-organisation of the hospital network, his plans will do little to improve the system if entry into it is restricted.
A patient’s journey through the NHS usually begins with their local GP and/or community pharmacist. In addressing the needs of the NHS, the minister would do well to start at the beginning.
