The lack of a government at Stormont in Northern Ireland is causing problems for important areas such as health and care, according to the British Medical Association (BMA).

BMA Northern Ireland Council Chair Dr Tom Black said the lack of government over the past two years has had a real impact. Although there are areas where some progress has been made, there are some policy decisions which need ministerial sign-off. He added: "That means, compared with the rest of the UK, Northern Ireland’s health and social care services have been at a real disadvantage."

Dr Black said the Queen’s University, Belfast, is the only place to study medicine in Northern Ireland. This means that, with a delay in establishing a new medical school, there is a shortage of doctors in Northern Ireland as well as an uneven distribution so that some parts are affected harder than others.

Plans are underway to establish a graduate-only medical school at Ulster University’s Magee campus. However, they cannot be fulfilled without ministerial approval. Dr Black explained: "There’s a real workforce crisis in general practice and hospitals in the north, west and south of Northern Ireland. We really need a second medical school. At the moment we have one medical school for two million patients, while there are six in the Republic of Ireland. But it takes a long time to train doctors, and even if the new school is signed off soon, we’re still talking about losing two or three years."

Although primary care has implemented ways of working to make better use of the wider health professional team, there is still an urgent need to make progress with radical transformation plans, which are largely put on hold with the suspension of devolution, according to the BMA.

GP practices are closing down and new pressure is being created on those that remain, as well as affecting patients’ care.

Furthermore, secondary care is experiencing rota gaps, creating additional costs for locum cover and affecting Northern Ireland's performance figures. By March 2019, more than 97,000 people were waiting more than 52 weeks for a first outpatient appointment in Northern Ireland, compared with less than 0.1% in England.

BMA Northern Ireland Consultants Committee Chair Anne Carson said: "Significant investment is needed to move forward effectively with transformation but that can’t happen unless there is a minister in place and the legislation to support change can’t be introduced without a legislative assembly."

In the absence of the legislative assembly, some consultations such as on stroke services and breast-assessment services have been conducted, although ministerial approval will be required before real action can be taken.

The BMA's article is available at

Last reviewed 9 July 2019