Former NI health minister Robin Swann has told the Covid inquiry that limited staff numbers and NI’s “ageing” hospital infrastructure made it difficult to respond to the pandemic.
The reality of the health crisis became “real”, Mr Swann said, when the first modelling for Covid cases without imposing restrictions arrived showing that NI could face 4,000 Covid-related admissions to hospitals per day.
The inquiry is currently considering the impact of the Covid-19 pandemic on healthcare systems in England, Wales, Scotland and Northern Ireland.
That includes healthcare consequences of how the governments and the public responded to the pandemic.
It will examine the capacity of healthcare systems to respond to a pandemic and how this evolved during the Covid-19 pandemic.
Nick Scott, counsel to the inquiry, referenced NI’s Chief Medical Officer Michael McBride, who was asked if the population of NI had the healthcare services that they needed at the start of the pandemic and said ‘no’.
And if Health and Social Care NI (HSCNI) was equipped to meet the needs of the population and replied ‘no’.
Robin Swann MP “fully agreed” with Mr McBride, saying there had been three years without a functioning Executive and the health service had been through single-year budgets from 2016.
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Necessary reform “had not been delivered”, he added, with services in NI “constrained” by the absence of funding and “political decision-making and political direction”.
When he took up post in 2020, health workers in NI were taking industrial action over pay parity and safe staffing.
Mr Swann conceded that NI did not have the capacity to respond to a pandemic.
The former health minister said the main factors hindering NI’s response was a “lack of available staff, space and capacity within the healthcare structures” and the estate was “ageing and in need of investment”.
When challenged on whether services were reorganised to maximise the available staff, Mr Swann said other services had to be “stepped down” in order to respond to the pandemic.
A letter marked ‘sensitive’ was sent in March 2020 was shown which highlighted that in a worst case scenario NI was set to face 32,000 daily cases with 4,000 daily hospitalisations ‘without behavioural interventions’.
The average daily beds available was 3,800 according to the document.
If behavioural interventions were applied by the Minister and Stormont Executive then modelling showed symptomatic cases could drop to 10,000 and hospitalisations to 1,200.
Mr Swann said those figures were “stark” and brought the reality of the pandemic into sharp focus and “made it real”.
He said this led to a “step change” in Stormont’s approach.
Without Covid restrictions, the healthcare system in NI would have been ‘crippled’.
Mr Scott challenged the Minister on why no surge plan for critical care was developed shortly after.
Under questioning, the former health minister conceded that he wasn’t providing a sufficient level of direction and put that down to inexperience in the role.