In Northern Ireland, health and social care have been part of the same structure since 1974; however, according to
Terry Bamford in 2015, "integration has failed to address a reliance on hospitals and institutional care, which is significantly greater than elsewhere in the UK." He said that there are various reasons for this. It is difficult to get resources out of acute care without closing buildings, which is a political problem particularly in rural areas. Information technology systems may not be compatible and patient confidentiality hinders the sharing of information. Health services are free but social care is means tested. But, "the greatest difficulties lie in the different cultures and values of health and social care." Until 2014, the
Kingsbridge Private Hospital in
Belfast was used to reduce waiting lists for routine surgery. In September 2015 the Northern Ireland Health and Social Care Board admitted that waiting lists for surgery had grown and that they did not have the money to pay either NHS providers or the private sector to bring them down. In 2015, the
NHS waiting list target in Northern Ireland was 52 weeks, not 18 as in England and 10% of healthcare provided in the region was paid for privately. A report by the
Nuffield Trust in 2017 showed that though spending per head in the province at £2,200 a year was much the same as the rest of the UK the performance of the system was much worse. Using the
NHS targets more than 20% of patients waited more than 4 hours in A&E departments, and sometimes 30%. About 16% of the population were on a waiting list, compared with around 7% for the rest of the UK. More than 64,000 of them, around a quarter, had been waiting over a year for their first outpatient appointment. In the last 16 years there had been seven government reports calling for a move to more stress on prevention and away from hospital based care. In 2018, hospital performance in the province was worse than the rest of the United Kingdom. All the five trusts failed their targets for A&E, cancer and routine operations for the whole of 2017–18. The Northern Ireland Audit Office reported in December 2018 that "the health and social care system, as currently configured, is simply unable to cope with the demands being placed on it." There is a deficit of £160 million and waiting times were unacceptable. None of the
NHS targets have been met since 2015. 204 patients died in hospital in 2018 while waiting to be discharged largely because of a lack of domiciliary care packages. In 2019, 205 homeless people in Northern Ireland died in an 18-month period, according to the
Bureau of Investigative Journalism accounting for more than 25% of the 800 homeless deaths in the UK. Northern Ireland's population of 1.9 million is 2.8% of the UK total. The BBC reported in 2019 the case of a woman with multiple health problems who moved from County Armagh to
Swansea and said the doctor she encountered in Bristol "was shocked" at the standard of medical care she had received from the
Southern Health and Social Care Trust. As of 2019, one in five Northern Irish cancer patients received their cancer diagnosis while attending an emergency department, because some patients wait too long on hospital lists and get taken to an emergency department instead. Heather Monteverde of
Macmillan Cancer Support described the statistics as, "shocking and extremely worrying". Monteverde said emergency departments are unable to give the highly specialised care cancer patients need and that just 55% of Northern Irish cancer patients begin treatment within the 62-day target, and the number was, "deteriorating month-by-month". Cancer patients presenting via emergency departments have the lowest survival rates. 74% of the 4316 patients who died from cancer in 2015 were admitted to emergency departments during the last year of their lives. Only 85% of suspected breast cancer patients were seen within the target period of a fortnight.
Health care crisis, 2022–2024 In May 2022 waiting times for outpatient appointments, hospital procedures, emergency care, GPs and community health services reached record levels. Tom Black chair of the
British Medical Association Northern Ireland said the crisis boiled down to "workload and workforce" issues. Nearly one-in-five of the total population were on hospital waiting lists. For a hip replacement patients can wait between five or six years to be assessed, and up to another five years for the operation. In February 2022, 16.3% of attendees spent more than 12 hours in an emergency department. From February 2022-January 2024 Northern Ireland was without a
devolved government. The DUP had boycotted the executive in protest over Brexit. In 2024, £3.3bn were to be spread across the public sector. ==Information technology==