Professor Deirdre Heenan:

As far as I am aware, there has been no development. It is my personal view that we will not move this area of policy forward until we have an all-island healthcare committee that has some ability to set out a strategic direction. What we have at the moment are well-meaning people working in areas where they are convinced they can make a difference, but it is an extraordinarily difficult ask for anyone who is already working in an overstretched healthcare system.

In terms of the two systems, sometimes, an awful lot is said. We need to take a step back and realise what the situation is, particularly in the North, which I know more about. Pre Covid, for example, we did some research in the north of England. We looked at a healthcare trust that had a similar population and similar population size to the North. In that area, ten people were waiting more than one year to see a consultant and this was deemed to be outrageous and shameful. The comparable figure for the North was 120,000. I say that because, sometimes, people hear that the system in the North is struggling and it washes over them in the same way as when we hear statistics, we sort of glaze over and think, "Have we not heard this before?" It is important to use those sorts of statistics to highlight how far behind we are in terms of our healthcare system.

With my other hat on, as someone who studies governance and models of devolution, I often say to our secretary of state our devolution settlement was based on the principle of parity between the devolved regions. How far out of kilter do we have to be in terms of our health and social care system until it is suddenly decided that we are not full citizens? We are so far away from an English system where it has just been announced that no one will wait longer than 18 weeks. We are asking people to wait eight years. Again, these are numbers but these are people waiting in pain, waiting without hope and dying unnecessarily.

Alongside this, almost in a parallel line, we have a conversation about economic inactivity rates in the North, as though the two were not interrelated. When we talk about the health committee, maybe the way to sell it is to say health is all of our business and is an economic issue. If cancer or some sort of health issue arrives at your door, that has a serious implication for your ability to be a taxpayer and to work and for your family, who may have to take on caring roles. Sometimes, health is viewed in isolation. People feel it has gone so far, they do not know where they would start. A much more logical way to look at it is the financial, economic, social and political implications of health. I cannot think of anything more important.