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Bengoa's Health Reforms: A Decade of Unfinished Business
7 Oct
Summary
- Bengoa review aimed for transformational healthcare change.
- Health service faces ongoing challenges 10 years later.
- Political will and funding are critical for future success.
Ten years ago, Prof Raphael Bengoa described Northern Ireland's health service as a "burning platform," necessitating urgent, transformational change. His 2016 review proposed shifting focus towards prevention and community-based care, supported by GPs. However, as of October 2026, hospital waiting lists, GP access, and social care conditions indicate the job is far from complete.
Despite lip service to the Bengoa ethos, political actions sometimes contradict its principles, especially with an election approaching. Prof Bengoa, visiting Northern Ireland again, stated that politicians must prioritize a unified vision for a world-leading health service. He highlighted the need for cross-party agreement and a multi-year budget, echoing the consensus achieved a decade prior. He stressed the critical role of GPs in this neighbourhood health model.
While some services are being consolidated, this has sparked public and political controversy, particularly in rural areas. Stormont's instability, including two collapses and the COVID-19 pandemic, has severely hindered progress. The pandemic, though disruptive, is seen by many as less of an impediment than ongoing political issues.
Improvements have been noted in emergency department waits and some elective lists are falling. However, Northern Ireland still struggles with the worst hospital waiting lists and missed targets, even in cancer care. The neighbourhood model has begun reallocating about 2% of the budget to community services, such as palliative care.
Professionals like Dr. Ursula Mason from the Royal College of General Practitioners emphasize the urgent need for investment to recruit more GPs, noting a decline in practices since 2016. Prof Deirdre Heenan and Prof Mark Taylor, a member of the original Bengoa panel, concur that sustained political will and courageous decision-making are essential for the report's recommendations to be realized. Taylor acknowledged improved collaboration among health trusts but noted extensive work remains.
