“New Decade, New Approach” – healthcare policy opportunities in Northern Ireland

by Eleanor Brady

After three years without a functioning government and political deadlock in Northern Ireland, the power-sharing agreement was restored in January with the publication of “The New Decade, New Approach Deal”. Published at a time of growing unrest in relation to healthcare issues in Northern Ireland, healthcare is of primary importance to the new government making this is a critical time for innovative healthcare companies to engage with the policymaking process in Stormont.  

The executive broke down in 2017 when Martin McGuinness, the leader of the nationalist party Sinn Féin, resigned in response to the Democratic Unionist Party’s (DUP) handling of a green energy initiative which ultimately cost the government £480 million. The breakdown of the executive left Northern Ireland’s civil servants to govern on their own, but with only limited powers.

Stormont – the commonly used name to refer to the Northern Ireland Assembly – allows Irish nationalists and unionists to share power in an executive, alongside a legislative chamber made up of assembly members which proposes and scrutinises legislation. Overall, it is a system known as ‘power-sharing’ which falls under the UK’s devolved system of government.

The executive exercises considerable independent control away from the UK Government, including over healthcare services following an Act of Parliament which made the Northern Irish Department of Health’s executive agency responsible for overall service provision.

With the government now restored, healthcare is said to be a key area of focus given the range of healthcare related challenges facing the country, not least Northern Ireland’s hospital waiting times which are among the longest in the UK. Data indicates that from 2018-2019, 105,450 people in Northern Ireland were waiting more than a year to see a consultant following a referral from a GP. In the same period in England, just 1,233 people were subjected to the same wait time.

Such problems have been compounded by the political deadlock between 2017-2020 as civil servants were left trying to follow the spirit of the last Health Minister’s decisions while avoiding any new policies which could have been controversial. Deirdre Heenan, professor of social policy at Ulster University, said on the waiting times: “if the assembly was sitting and a health minister was being asked every day about these numbers, then eventually he or she would have had enough and start working on a fix. That is not happening.” The tension reached boiling point in December 2019 when a 20,000-person strike took place, attended also by the Royal College of Nursing marking the first time in its 103-year history it has joined such a strike.

Against this backdrop, many are understandably relieved that the government has been restored. The new health minister, Robin Swann (Ulster Unionist Party) has spoken on delivering on the executive’s previous healthcare commitments as set out in the 2016 report “Health and Wellbeing 2026: Delivering Together”.  Their health policies aim to decrease staff pressures and hospital waiting lists, improve patient experience and population health, add 900 additional nursing and midwifery undergraduate places, and publish a new mental health plan.

This is therefore an opportune moment for the healthcare business community to engage with policymakers in Northern Ireland given the raft of proposals and consultations which will ensue. The region already has a strong base of healthcare companies and manufacturing sites, as well as two universities which rank among the top 10 in the UK for bioscience research. The region’s clinical specialisms are said to be within the areas of oncology, cardiology, ophthalmology, respiratory and diabetes.

As well as these immediate opportunities, the macro picture of political power in the UK is one of increasing divergence from Westminster, with all main parties committed to stronger and more empowered communities through various forms of devolution. Hence, engaging in the devolved administrations couldn’t be more important at this time, and particularly in Northern Ireland where the resurgent nationalist party Sinn Féin – who received their best set of results in the recent election in the Republic of Ireland – will use their emboldened position to frustrate for more powers in pursuit of their ultimate ambition: Irish reunification and independence from the UK.



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