Reform needed to stop people ‘voting with their feet' on private healthcare, says Professor Bengoa

Reform of Northern Ireland’s healthcare system is needed to reverse the hordes of patients flocking to the private healthcare sector, Professor Rafael Bengoa has said.

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The international healthcare consultant was back in Belfast on Wednesday, eight years after he penned a ground-breaking report plotting the way forward for reform of our health system. Despite the Executive’s endorsement, progress in implementing the 2016 report’s suggestions has been slow, delayed by two separate collapses in devolved government and the impact of the Covid-19 pandemic. Ahead of the Department of Health’s Accelerating Change conference at the La Mon Hotel, Mr Bengoa said that though progress had been limited, it was unfair to suggest there had been a failure to implement the reforms.

"I see this (the conference) as progress; I think all policies – especially in healthcare – need a reboot from time to time, a re-energising,” he told the Belfast Telegraph. "Many things have been taking place, but the trouble is that many of those maybe haven’t hit the ground. We know we have a battery of tools that helps us move forward and accelerate things, that we didn’t know then before.



"For example, surgical hubs, new ways of using non-GPs in primary care and of course artificial intelligence, which is coming into the system. "We have new management tools that are going to help us accelerate change from now on.” The health expert said the flow of patients towards private care was not limited to Northern Ireland and showed people were concerned about the public sector.

"I defend very forcefully the need to re-energise the public system, because people are beginning to vote with their feet all over Europe,” he said. "It has been expressed in a stronger way because of the pandemic, in which people are seeking both private insurance and private providers as an alternative because they are not getting what they expect out of the public system. "People have to understand that in system terms, that is not a solution; what we need now is to fund and make an important investment in the public system to make sure it can deal with the pressures it has with all the demographic and chronic disease demand.

” Mr Bengoa said political parties had to put ideology to one side when dealing with crises in healthcare. "In places where things are working, governments and politicians started working together across ideological colours,” he said. "That’s very important because that is the type of political arrangement we need at a moment where the health services are having a crisis moment.

"It’s not something that can be resolved within the health ministry; it has to be resolved across government. "Success would mean we have re-energised things and the government has been able to work together across political groups and demonstrate progress on formal healthcare but also the broader health agenda.” Health Minister Mike Nesbitt said healthcare reform was not the sole responsibility of his department.

"I am very keen that we look at the inequity in terms of access to healthcare and that is going to be a challenge as we move towards this new system that I want to introduce,” he said. "I have been talking to the Minister for Infrastructure and also the Minister for Agriculture, the Environment and Rural Affairs..