MONEY! MONEY! PUBLIC MONEY! 

Nearly 945 Million Pounds for the whole of the Southern Trust in 2021-2. Nearly How much of this c. £945 million was spent on Specialist Acute Inpatient Services and Emergency Services in Daisy Hill Acute Hospital, Newry in 2021 -2022?

Hospital services are paid for with public money – funded by your Regional rates, Taxes and National Insurance Contributions. In 2021/22 The Southern Trust had an income of £944,707,000* (nearly £945 million).  Management costs were £29,092,000* (c £29.1 million).   

>How much of this c. £945 million was spent on Specialist Acute Inpatient Services and Emergency Services in Daisy Hill Acute Hospital, Newry in 2021 -2022? 

>How much of this c. £945 million was spent on Specialist Acute Inpatient Services and Emergency Services in Craigavon Hospital in 2021 -2022?

>Are Newry & Mourne population (the largest LGD /locality population in the Southern Trust) getting VALUE FOR MONEY?

Redress the unbalanced NI Stroke Consultation 2019 - additional Options needed to include the Excluded populations.

There are TWO Government designated Acute Hospitals in the Southern Trust – the longest established is Daisy Hill Hospital, Newry city which is situated in the Newry & Mourne LGD –CONSISTENTLY THE HIGHEST LOCALITY/LGD population in the Southern Trust.

Newry & Mourne, South Armagh Acute Area Hospital at Daisy Hill, in Newry city
Graphic by Daisy Hill for life

The second Acute Hospital is Craigavon Hospital in Portadown (situated in Craigavon LGD -the second largest locality population in the Southern Trust area, where Newry & Mourne LGD is the highest population)

CRAIGAVON HOSPITAL REDEVELOPMENT PRIORITISED AGAIN (p43 OF SOUTHERN TRUST LATEST ANNUAL REPORT)

The Southern Trust Annual Report & Accounts 2021-22 gives information on how much is being spent overall in the Southern Trust – but the public need to know that the money is being spent FAIRLY across its acute hospitals according to population size/need.  

The public need to know this especially because Craigavon Hospital redevelopment once again gets prioritized in the Southern Trust 10 year Capital Long term Expenditure Plans (p43) but despite the long overdue population-based need and requirement in Newry & Mourne –there is NO MENTION of Long Term Expenditure Plans for the Redevelopment of Daisy Hill Hospital , Newry city, in this same 10 year review of capital priorities statement, as shown quoted below:

“as part of a 10 year review of capital priorities, the Southern HSC Trust has identified a need for investment in excess of some £430m. THIS INCLUDES REDEVELOPMENT OF CRAIGAVON AREA HOSPITAL together with much needed infrastructure, backlog maintenance and diagnostic equipment requirements.”

Southern Trust Annual Report & Accounts 2021-22 p43

This Southern Trust Annual Report and Accounts 2021-22 can be accessed and read in full from the link at the end of the article under Background and References.

IMPORTANT: WHCH LOCALITIES (LGDs) ARE INCLUDED IN THE SOUTHERN TRUST AREA?

IN LEGAL TERMS the Southern Trust area includes ONLY 5 (former) LGDs of (1) Newry & Mourne, (2) Craigavon, (3) Armagh, (4)Dungannon and (5) Banbridge. (Ref: Establishment Order 2006)

The 2006 Order also makes it very clear that accommodation and services should be provided in each of six named hospitals, with addresses, including Daisy Hill, Newry.  It does not say all hospital accommodation and services should be centralised to Craigavon only as the Southern Trust are determined to do.

The operational area of the Southern Trust is NOT Armagh, Banbridge and Craigavon; Mid-Ulster; and Newry, Mourne and Down council – This Southern Trust Annual Report has got this wrong on the Southern Trust operational area on p9 of the Southern Trust Annual Report & Accounts 2021/22.

Important:

In Legislation ‘Down’ is in the operational area of the South Eastern Trust and ‘Mid Ulster’ (Cookstown and Magherafelt) are in the Northern Trust.

HEALTH SERVICES COMMISSIONING

The number of people living within a locality (LGD) and assessed population need is supposed to be the primary factor when commissioning health Services so as Newry & Mourne LGD is the highest locality population in the Southern Trust – this should also be reflected in the funding spent on Daisy Hill Acute Hospital, Newry and its Specialist Acute Inpatient services and Emergency services.

Time for Investment in Newry and Mourne LGD's acute Hospital Daisy Hill

Daisy Hill Hospital, Newry was designated in its own right one of the 9 major Acute Hospitals in NI since 2003 (as part of Developing Better Services). As such it is entitled to funding for a fully functioning acute hospital with 24/7 Consultant Led Accident and Emergency Services and 24 /7 Consultant Led Maternity Services.

It was not designated as a ‘support or local hospital’ to Craigavon (as the Southern Trust nominated it to be in 2010) or designated just as a regional elective centre as has been decided without any form of Consultation WITH THE PEOPLE WHO ARE PAYING FOR a fully functioning acute hospital.

Newry & Mourne LGD needs re-imbursement for Hospital funding due to population plan errors in the Southern Trust area > For vitally important information and explanation why Daisy Hill, Newry requires this re-imbursement for Hospital funding due to crucial errors -see the Daisy Hill for Life website – by clicking on the picture LINK below:

BACKGROUND AND REFERENCE

 (* Source: Southern Trust SHSCT Annual Report & Accounts 2021-22 for the year ended 31 March 2022 (pg 115, 43, 9)
Link below: https://southerntrust.hscni.net/about-us/annual-reports/


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NI Health Crisis – Cut in Specialist Acute Hospitals & their Uneven spread since 1995 is a major factor

Nurses and Health Workers in N. Ireland strike for pay parity, safe staffing levels Dec2019

2019 ended with Northern Ireland’s Health Care in crisis: Patient Waiting lists at record highs, healthcare workers on strike over pay and staffing levels, Nurses from the Royal College of Nursing on strike for the first time in its 103 year history. This ‘crisis’ is recognised by the Royal College of Surgeons, the Royal College of Nursing and Health Unions

NI Nurses and Health Workers province-wide strike January 2020

Health Care workers on strike here have been short changed in comparison with the rest of the UK, on pay and staffing levels. But in terms of Acute Hospital Care, are people in Northern Ireland being treated fairly in the number and location of specialist acute hospitals?

Before NI can start to fix the current Health Care Crisis –some background is necessary to find out how it got to this point.

There were 19 Acute hospitals in NI in 1995 as the map below, reproduced from The Department of Health’s Regional Strategy (1997 – 2002) shows.

Hospital map Northern Ireland with populations 1995 -shows acute hospitals.

According to the Department of Health:

“If the ratio of acute hospitals to population which currently obtains in England were applied to Northern Ireland (1,649,131 in 1995) there would be no more than 10 acute hospitals in NI. Thus many acute hospitals in NI serve much smaller populations than acute hospitals in England.”

Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002)

Direct Rule Health Minister Mr Moss stated in a Hansard Report 5 March 1997:

The Department’s Regional Strategy for 1997 to 2002 was published last year and envisaged specialised acute hospital services being built around the cornerstone of Northern Ireland’s six major hospitals- the Royal Victoria hospital, the Belfast City hospital, Craigavon, Antrim, Altnagelvin and the Ulster.”

It clearly states also that:

While investment where appropriate will be made in other hospitals, it is expected that those SIX HOSPITALS will provide the main focus for FUTURE INVESTMENT in INPATIENT FACILITIES.”

Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002) p65

These 6 hospitals out of 19 hospitals were envisaged as specialist acute hospitals, because of hospital size, NOT based on where the largest settlements of population lived, compared to England who the strategy stated would have 10 hospitals for a population the size of NI (1,649,131). The mid-year 1995 NISRA populations (Table) prove this.

They show that Daisy Hill acute Hospital, Newry & Mourne LGD – the FOURTH largest population (84,035) in NI, and Lisburn LGD (106,583), the SECOND Largest population in NI were COMPLETELY IGNORED for consideration as one of 6 major acute hospitals, while 3 other acute hospitals serving SMALLER populations in the local Government Districts of Craigavon, (population 77,689) Antrim (48,489), and Castlereagh (64,616) were listed for preservation.

Accurate population demographics, as provided by NISRA must inform health planning and future investment in inpatient facilities across NI

This trend of ignoring population size has continued into the present (as the next post will show), so to truly combat the Northern Ireland wide health crisis – ACCURATE DEMOGRAPHICS provided by NI Statistics and Research Agency (NISRA) must inform health planning. This includes using these official statistics, as presented by NISRA to determine WHERE Specialist acute Hospitals and specialist inpatient and outpatient acute services are located.

Acute Hospital accommodation and services are paid for through Rates and Taxes by everyone, irrespective of where they live in NI – Urban or Rural, everyone is entitled to equality of access to Hospital Care.

Further posts will look at the present and future NI Demographics in relation to location of acute hospital provision.

Official statistics, as presented by NISRA must determine where Specialist acute Hospitals are located in NI.

BACKGROUND
A Short History – Pre Centralisation – In 1995 there were 19 ACUTE HOSPITALS in Northern Ireland. (See Map or Full List at End of post.)

1995: All NI population: 1,649,131*

1995: 15 LARGEST POPULATION SETTLEMENTS IN NORTHERN IRELAND (Statistics from NISRA*)

(1st) Belfast: 288,932; (2nd) Lisburn: 106,583; (3rd) Derry: 102,123; (4th) Newry & Mourne: 84,035 (5th) Newtownabbey: 78, 426; (6th) Craigavon: 77,689 (7th) North Down: 75,519 (8th) Ards: 68,462 (9th) Castlereagh: 64,616 (10th) Down: 61,441.
[(11th) Ballymena: 58,039 (12th) Fermanagh: 55,405 (13th) Coleraine: 54,176, (14th): Armagh: 52,675 (15th) Antrim: 48,809 [NISRA]*

19 ACUTE HOSPITALS IN 1995 NI (Alphabetical order)
Altnagelvin (Derry); Antrim; Ards; Banbridge; Causeway (Coleraine); City (Belfast); Craigavon; Daisy Hill (Newry); Downe; Erne (Enniskillen); Lagan Valley (Lisburn) ; Mater (Belfast); Mid-Ulster(Magherafelt); Route (Ballymoney); Royal Group (Belfast); South Tyrone; Tyrone County (Omagh); Ulster (Castlereagh); Whiteabbey (Newtownabbey).

Sources:
NI Regional Strategy for Health and Social Wellbeing (1997- 2002) ‘Health and Wellbeing into the Next Millennium’

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