Northern Ireland

Health Review 2014 - emergency departments 'at breaking point'

Emergency department sign Image copyright PA
Image caption Northern Ireland is the worst performing region in the UK for seeing patients in emergency departments within four hours

As 2014 limps to a close, an emergency department crisis is gripping England.

In Northern Ireland, patients and staff had been coping with similar problems throughout the year, and most of the previous year.

It came to a head in January of this year when BBC News NI revealed that an emergency incident had been declared in the Belfast Health Trust.

Too many patients and not enough staff brought a department to breaking point.

It also brought the issue to a head within the Belfast Health Trust and the Department of Health.

Patient safety and dignity were highlighted, and staff said they could no longer work under such difficult circumstances.

A BBC Spotlight NI investigation revealed that waiting to see a doctor in the Royal Victoria Hospital's (RVH) emergency department may have been a contributing factor in five patients deaths.

Leaked copies of serious adverse incident reports revealed how seriously ill patients were not seen within acceptable timeframes.

Image caption Sir Liam Donaldson held the post of chief medical officer for England for 12 years

The incident, and adverse publicity, triggered a number of independent reviews including from England's former chief medical officer, Sir Liam Donaldson.

That report is due to be with the department by 31 December.

Health cuts finally met their Waterloo with news that the five health trusts had to make savings across the board.

Hard-hitting, they would mean fewer home-care packages for the vulnerable, while waiting lists for elective procedures, such as knee and hip operations, were soaring.

The measures, described as temporary, included closing over 100 hospital beds and wards at the weekend. Fewer bank and agency nurses would also be employed.

People power overturned some decisions, including a reversal to close Bangor's minor injuries unit.

Also, a consultation on the future of Dalriada Hospital in Ballycastle hung in the balance after a Multiple Sclerosis (MS) patient won her judicial review over the decision to close the MS unit.

While the health unions remained steadfast in their challenge to cuts and those at the helm, there were considerable changes in those people in charge.

Image caption Health Minister Jim Wells, from the Democratic Unionist Party said he believed protecting the unborn child and supporting the concept of marriage were "best for society"

In September, a DUP reshuffle meant goodbye Edwin Poots and hello Jim Wells. The new minister told the BBC he would not abandon his religious principles when making policy on issues like abortion and alcohol.

Unprecedented

While the Department of Justice is carrying out a consultation on the first matter, another one has begun regarding setting a baseline price below which alcohol cannot be sold.

The chief executive of the Belfast Health Trust resigned in March. Nine months later and the post has yet to be filled. Instead, in an unprecedented move, the chief medical officer Dr Michael McBride is temporarily performing the two roles.

Tony Stevens stepped down as medical director of the Belfast Health Trust to take the helm in the Northern Trust.

The Chief Executive of the Health and Social Care Board, John Compton, retired, with Valerie Watts returning home from Scotland to take up the post.

Another important issue in 2014 was the future of paediatric cardiac services at the RVH.

A well-fought public campaign resulted in the service being moved to Dublin.

There was much disappointment about part of the service at the RVH closing, but a majority of parents were happy their fight had resulted in the development of an all-Ireland service as opposed to it moving entirely to England.

2014 was another year when whistleblowers and the organisation Patients First made a difference to the health service.

After a BBC series on the treatment of elderly residents in local care homes, the Commissioner for Older People called for tougher measures to be taken to ensure elderly people in homes were protected from cruelty and abuse.

Image copyright PAcemaker
Image caption Una Crudden campaigned to raise awareness of ovarian cancer

The emerging names and personalities of 2014 included Una Crudden.

Una worked tirelessly to raise awareness of ovarian cancer. While she lost her own fight against the disease in December, she won her campaign for better understanding and publicity around the issue.

Women in Northern Ireland and elsewhere should be grateful for her tireless efforts.

Residential care homes got a temporary reprieve, but, like other services, some tough decisions will have to be made on their future in 2015.

Prof Philip Lamey was struck off the dental register. The sanction was imposed by the General Dental Council that had earlier found him guilty of more than 100 charges of misconduct. Following a late diagnosis of cancer four Belfast Health Trust patients died.

So, as we head into 2015, the big question is can Jim Wells be the man to deliver? Or will the public remind him and others that, with an election looming, cuts to services will not win votes.

2014 has been a busy year. Looking forward to 2015, there will be many hoping that the cancer drugs fund makes lots of loud noises in Northern Ireland while Ebola remains quiet somewhere in the background.

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