The Big Conversation

Posted on July 22, 2011 by stephennicholl The Big Conversation is the phrase used by some in the health care field to describe the process that we in Northern Ireland must go through in defining the future of our health services. It defines the need to be open about many of the real issues that affect the health of our community and the services that are provided to help them. As a former non-executive Director of the Public Health Agency I am well aware of the demands placed on resources by an acute health sector which struggles to meet expectations, at the same time limiting the ability of the sector to invest in the development of a service fit to meet future demands. The transformation currently underway in Belfast is about delivering better services. This should always be the driving force in health service change. While some politicians will always demand everything for their own constituency the reality is that sometimes demands for buildings are not met with the delivery of appropriate services. Making people better, sooner should take priority over keeping ineffective, inefficient and sometimes dangerous services operational simply because of where they are. Stopping people becoming ill in the first place by addressing the social determinants of health such as poverty must be seen as the longer term mechanism to reduce the cost of provision of acute services. The challenge in this process is not that there will be too much change but that there won’t be enough or that the funds required to truly transform delivery will not be available.