Is health reform finally getting underway? There are mixed signals. Mike Nesbitt has announced he will publish a three-year strategic plan and a hospital reconfiguration review within six months.
The UUP health minister said he is “not afraid to take tough decisions” on centralisation, even if people have to travel further for treatment. He has invited back Professor Rafael Bengoa, author of Stormont’s stalled 2016 reform policy, to regain “all-party buy-in” for changes that will involve other departments, especially on transport.
However, Nesbitt wants reform to be based around addressing “health inequalities”, a vast socio-economic issue involving so many factors beyond the health service’s control it could be more of a distraction than a mission.
The minister already has a long list of straightforward, essential and overdue improvements sitting on his desk. He could prioritise them and get on with it.
Nesbitt’s ‘Live Better’ programme to tackle health inequality will be piloted in two areas before being rolled out across Northern Ireland. Alan Stout, regional chair of the British Medical Association, has welcomed the concept in principle but noted it will largely involve more people being told to contact their GP “so you’re better to just fund and support general practice in the first place”.
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Among the announcements postponed for the general election is that the Office of Environmental Protection (OEP) is investigating Stormont’s Department of Agriculture, Environment and Rural Affairs.
The department’s Alliance minister, Andrew Muir, will not be displeased. The investigation is over the failure to adopt an environmental improvement plan as required by the 2021 Environment Act, a law the Greens steered through Stormont. Muir has been trying to adopt such a plan, focused on Lough Neagh, since taking office in February. He is reportedly being blocked by the DUP.
The OEP is an oversight body in England. It acquired jurisdiction here in 2022 as a compromise with the DUP, rather than creating an independent environmental protection agency. Ensuring adoption of environmental improvement plans is part of its remit.
It would be a bit grand to say anyone at Stormont is playing 4D chess but Muir appears to one move ahead at noughts and crosses.
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The government is planning a recruitment drive for teachers in England, aiming to increase headcount by 6,500. The Ulster Teachers’ Union has warned this will poach staff from schools here.
The union’s motivation is to argue for a pay rise but there are other opportunities to explore. Northern Ireland produces far more teachers than it needs, partly due to the duplication of state and Catholic teacher training colleges.
In 2013, an Alliance attempt to merge them into a single system revealed the high degree of resistance any such reform would entail. So why not embrace our regional specialisation as a supplier of teachers to Britain?
One argument against it is that Stormont’s tuition fee subsidy means it costs us to prepare teachers for export, unless they come from Britain to be trained, in which case they pay full fees. Is it beyond the wit of all concerned to turn this into a lucrative activity?
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First-past-the-post normally produces disproportionate outcomes that crush smaller parties. By a combination of luck and local circumstances, last week’s general election delivered a remarkably accurate outcome in Northern Ireland.
The two smallest winning parties by vote share, the SDLP and the TUV, got exactly the ‘right’ number of seats. Sinn Féin got two more than its share, the DUP one more and the UUP one less. Only Alliance really has grounds for complaint: it has one seat when it could have expected three under proportional representation.
Not only did unionism win the correct number of seats overall but the spread across its parties is almost in proportion - switch one of the DUP’s five seats to the UUP and the fit would be perfect.
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The DUP lost three seats in Westminster but it is gaining one at Stormont. Alex Easton, the new quasi-independent unionist MP for North Down, has co-opted a DUP councillor into his vacated spot in the assembly.
This will bring the DUP to within one seat of Sinn Féin, raising the question of whether the DUP could demand the first minister’s post with one or two more defections. The short answer is no: a party can only claim the post when an executive is formed.
The DUP would have to collapse Stormont then try to have devolution restored without an election, as happened in 2020 under New Decade, New Approach. That would require Sinn Féin’s cooperation, which is unlikely to be forthcoming.
A better question is whether it is ever legitimate for either of Stormont’s two largest parties to trigger an election at a time to their advantage. This is considered normal politics in most democracies.
The next day’s headlines reported Pat Cullen, as RCN chief, would settle for a 10% pay rise for nurses. Two months later she accepted 5%. If you measure this negotiation in terms of table legs, Cullen would have had only one left
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Much attention has been paid post-election to the transformation of East Derry from a safe DUP seat to a marginal, with Sinn Féin almost unseating Gregory Campbell.
This has overshadowed the intriguing outcome in East Antrim, which has become a three-way marginal. DUP incumbent Sammy Wilson’s vote fell by a half to 11,000, the UUP’s rose by a half to 9,000 and Alliance held steady at 10,000.
East Antrim is now where Alliance and the UUP each have the best chance of growing from a one-seat wonder to a multi-seat Westminster party (just about). That competition will be the DUP’s best hope of hanging on. Incumbency at the next election is not assured, if it is still an advantage. Wilson and Campbell are both 71.
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New Sinn Féin MP Pat Cullen has defended Westminster abstentionism, saying that as head of the Royal College of Nursing she forced the government “to come to my table”.
This is a generous recollection of events. In 2022, the RCN embarked on the first national strike in its history for a 19% pay rise, when accounting for inflation. After three weeks of ministers dismissing this out of hand, Cullen told a Times podcast the government should “meet me halfway”.
The next day’s headlines, doubtless encouraged by government briefing, reported she would settle for 10%. Two months later she accepted 5%. If you measure this negotiation in terms of table legs, Cullen would have had only one left.
