Understand
A decade on from the Bengoa report, how much has Northern Ireland's health service changed?
Overview
Ten years after Professor Raphael Bengoa published his landmark 2016 review calling for fundamental reform of Northern Ireland's healthcare system, hospital waiting lists, GP access, and social care issues indicate that much of the work remains unfinished. While some service consolidation has begun and initiatives like the digital Encompass record system have improved efficiency, political instability, funding shortages, public resistance to moving services, and the COVID-19 pandemic have heavily hindered transformation. Professor Bengoa has returned to Northern Ireland to urge politicians to find cross-party consensus and long-term funding, stressing that strengthening general practice and community care is vital for sustainable health services.
Key points
- Professor Raphael Bengoa's 2016 review warned that Northern Ireland's health service was unsustainable and needed to shift focus from hospitals toward community care and prevention.
- A decade later, transformation has fallen short of ambition due to political instability, collapsed Stormont administrations, the COVID-19 pandemic, and a lack of multi-year budgets.
- Northern Ireland continues to face severe hospital waiting lists and health trusts are still missing official waiting time targets, including for cancer services.
- Efforts to consolidate specialist services across hospitals—such as changes involving the Causeway, South West Acute, and Daisy Hill hospitals—have sparked political crises and strong public opposition.
- General practitioners argue that implementing the neighbourhood care model requires urgent investment and more staff to cope with a rising patient population and falling practice numbers.
- Some improvements have been noted, including a digital single record system, a 2% shift of budget into community services, and slight reductions in some elective waiting lists.