Collapsing Stormont before the end of the Assembly term would endanger vital reforms aimed at reducing Northern Ireland’s spiralling waiting lists, the Health Minister has warned.
Robin Swann said it was not realistic to expect the health service to function properly in the absence of a powersharing administration.
Mr Swann said any party that brought down the institutions during the Covid pandemic, and when so much work was needed to tackle what are the UK’s longest waiting lists, would do a “disservice” to patients and healthcare staff in Northern Ireland.
The minister’s comments come amid repeated threats from the DUP to withdraw its ministers from the Executive in protest at the Northern Ireland Protocol.
DUP leader Sir Jeffrey Donaldson has said while that option remains on table, he has paused the threat pending the outcome of the latest round of negotiations between the UK and EU to resolve issues with the contentious post-Brexit trading arrangements.
Last summer, Sinn Fein also threatened the future of the administration in Belfast when the party warned it would not continue to be part of an executive without progress on stalled Irish language legislation.
Thanks to Stormont’s mandatory powersharing structures, a functioning executive can only be constituted if the largest unionist and largest nationalist parties are part of it.
In an interview with the PA news agency, Mr Swann said: “For the sake of all those people who are on a waiting list, for the sake of all those people who work in our health service, this place needs political leadership.”
While the current mandate is due to end in March, ahead of an anticipated election in May, Mr Swann said the next two months were vital if the Assembly was to have the time to pass its first multi-year budget in a decade.
The draft budget is proposing a 10% increase in health spending, with £21 billion earmarked for services over the next three years.
“Our biggest challenge within health has been the systemic underfunding for the past 10 years,” said Mr Swann.
“But what was compounded with that was a one year budget rotation that didn’t allow us to invest in the health service or make those transformational changes that we needed to do or actually put people into posts for the long term, because we didn’t know the budget was going to be there (in future years).
“So at this moment in time we have a potential draft three-year budget out for consultation. The timeline on that consultation finishing and by the time it goes through the Assembly that runs us into the end of this mandate.
“So if there’s no institution there, there’s no Finance Minister to make those decisions, there’s no Health Minister then to utilise what the health allocation is strategically – that’s where we go back to that one year rolling budget that doesn’t allow health to make the strategic changes that need to be done.”
Mr Swann said the health service “doesn’t work” without an executive in place.
“We need the Executive there making those collective decisions, we need the Assembly there to make those decisions as well and to get legislation through,” he said.
“To think that collapsing the institutions will leave health able to do what it’s doing, I don’t think is realistic.
“It will put us back into the position that we were in before January 2020 (when Stormont was last collapsed) where although the health service was existing and it was doing things, it wasn’t able to do the structural strategic changes or make those decisions that were actually needed.
“So it would be a retrograde step and I think it would actually be a disservice not just to the people in Northern Ireland who are on waiting lists but it would also be a disservice to the people who are working in our health service as well who actually need some of those decisions, those strategic political decisions, to be made and followed through.”
Mr Swann added: “I think the majority of my DUP colleagues recognise that the institutions actually deliver for the people of Northern Ireland.
“Coming from a health point of view, there’s actually been more DUP health ministers since devolution than any other party, so they know the strategic value that the transformation of health brings, but they also know that there has to be strategic investment and change as well.
“So my message to all politicians, including MLAs and MPs as well and not directed to any specific party, is it’s about actually taking the politics out of health.”
Mr Swann also cautioned rivals against putting constituency politics above the need to support reform of the health system.
He expressed concern that as the election approaches some politicians may be unable to resist the “temptation” to campaign against any changes to how services are delivered in their locality.
He insisted there were no plans to close any hospitals in Northern Ireland but said there was a need to realign and consolidate how some services were delivered.
The minister said the pandemic had demonstrated that people were prepared to travel further to access treatment if it meant a reduction in their waiting time.
“My concern would be that now we’re actually entering into an election period that people do start to play politics with health,” he said.
“I think that will be a retrograde step, I think it would be unforgivable really.”
The minister added: “There’s no hospital under threat. We need every square foot that we have, in fact probably more, but it’s how we utilise that to actually reduce waiting lists and better serve the patients that need to be seen quicker.”
Mr Swann said while the pandemic had “side-lined” many of the planned structural reforms of the system it had also hastened some of the required changes to working practices, including around the issue of parts of the health service operating in isolated silos.
“What we’ve seen in the past two years is a real coming together,” he said.
“You’ve got primary care working with secondary care, we’ve got our GPs connecting into hospitals, care homes. Community pharmacy now playing a major part in our community and health and social care response. So there’s a lot of those silos have been broken down.”