Having a programme for government is better than not having one, but beyond that the production of this ‘plan for the future’ is hardly a cause for celebration. In the bizarre world of politics in the north, many lined up to congratulate the Stormont government on being able to agree on nine priorities and produce an 88-page document.
Criticism and highlighting glaring shortcomings were swatted away as deeply unhelpful and unnecessarily negative. The doomsters and naysayers should not be allowed to spoil the party. Only Panglossian views are permitted.
The first and deputy first ministers hailed this plan as a milestone, a remarkable achievement. The Deputy First Minister noted: “We want to build on the fact that we are global leaders in key sectors as cyber, fintech and health and life sciences.” She added that “we make no apology for being ambitious”.
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Apparently the nine priorities were thrashed out after “complex negotiations”, but with the best will in the world it is difficult to understand why and how it took seven months to agree this list.
According to Emma Little-Pengelly they focused on what they could agree on, as though our executive should be congratulated for finding some common ground. One would imagine that the long-standing issues such as health and the economy would have been exhaustively debated and discussed in the two years that the executive was in abeyance. Many of these ‘priorities’ are in fact actions that should be viewed through a much wider policy lens.
By contrast, in Scotland John Swinney set out his first programme for government in September, listing only four priorities: eradicating child poverty; building prosperity; improving public services; and protecting the planet. Significantly it is accompanied by a supportive legislative programme.
Peel back the rhetoric and the platitudes and our draft programme for government is business as usual. It is not a practical plan for dealing with the deep malaise in the public sector. It reads like a wish list or a party manifesto.
In many respects it poses more questions than answers. Where is the substance, the costed strategies, the pivot away from old ideas towards new ones? We are told that the eight weeks of consultation will provide more flesh on the bones, but frankly that is ludicrous.
Given the dire state of our health and social care system, it would be hard to imagine that it would not be writ large in any list of priorities. Oddly though, rather than transformation of the system, the priority was expressed as to “cut health waiting lists”. Waiting lists are a symptom of systemic failure, not the problem in themselves. They are not a backlog to be cleared, but an illustration of the pressures within the system.
The scale of the task is not discussed, nor the fact that our waiting lists are by far the longest in the UK; no ownership of this dire position, no acknowledgement of the impact of previous failings. It is about time that government accepted responsibility for the fact that without decisive action, it is denying patients timely access to lifesaving treatment.
With reference to the waiting lists, one might have expected a focus on four areas of operational delivery: increasing health service capacity; prioritising diagnosis and treatment; transforming the way elective care is delivered; and better information and support for patients.
There is no sense of urgency, no focus on problem-solving, no empathy for the citizens who are suffering in the most intolerable way. The public do not need more meaningless cliches and waffle about being world leading when they cannot access basic services
We could have been given details on plans to offer more people access to treatments in the private sector, targeting of those who had been waiting the longest, the development of community diagnostic centres, surgical hubs and a timetable for the reinstatement of the cross-border health directive - an ambitious, detailed blueprint setting out key objectives, milestones and targets.
Setting out targets for overall waiting list numbers can be complicated - they are difficult to predict - but metrics for treatments, productivity and new modes of delivery are perfectly possible.
Instead, this “ambitious” document states that waiting lists are out of control. It even helpfully provides a chart to illustrate how dire the situation is. It then concludes that, alas, we don’t have the money to deal with this life and death issue. That’s it. That’s as good as it gets.
Funding is not the be-all-and-end-all. It is difficult to see any path to a meaningful reduction in waiting lists that does not include a substantial increase in health service productivity. This must be acknowledged and addressed.
Despite the hope generated by the new UK government’s pledge to increase investment in the devolved regions, does anyone really believe that more money will translate into tangible change?
In a nutshell, it is a well-worn story; warm honeyed words and flimsy platitudes about making the north globally competitive. More of the uninspiring, thin gruel that we have been served up for decades. There is no sense of urgency, no focus on problem-solving, no empathy for the citizens who are suffering in the most intolerable way. The public do not need a word salad dressing with lashings of inane drivel about being world leading when they cannot access basic services.
If civil society, academics and the community and voluntary sector are to discharge their role of critical friend and effectively hold this government to account, we need a far a more comprehensive and detailed plan which clearly and transparently sets rights-based targets for achievement in key policy areas. Change is difficult, it involves hard choices, the cost of prevaricating is immeasurable.
We need a government to take responsibility, a government to be accountable, a government to deliver.
