Are politicians needed? That is the question that arose from speaking with Professor Rafael Bengoa while he attended the Pathfinder Health Summit in Enniskillen this week.

Professor Bengoa is the author of a report: ‘Health and Wellbeing 2026: Delivering Together’, into the future of health provision in Northern Ireland. Before the collapse of the assembly the report had received the widespread backing from political parties.

When asked was he frustrated that after his report received this backing the institutions came crashing down he said he “did not have that feeling at all”.

“If anyone should be frustrated it is the politicians who are maybe asking ‘What? You are doing things without me’. I can see things working from a bottom up way, like we see today with Pathfinder. This is a perfect example of what we have been talking about. You didn’t need politicians to make things happen in this case”, he said before adding:

“Obviously there are other examples where you need politicians, such as the second medical university in Londonderry that we have just heard about it. Politicians will be needed for decisions like that but there can be real change from the bottom up without politicians.”

Professor Bengoa also revealed that while “the health system is very generous” in Northern Ireland, the West did not have the health services that it needed.

“There needs to be more and better primary care, more prevention, more treatment in the community, away from hospitals. Better use of digital technology. That is where the shift has to happen,” he said.

Professor Bengoa also said that society had to make decisions about its role in healthcare and that people had to take more responsibility about how they live their lives.

“The population has to start understanding that they own their life course and the decision they are taking throughout their life in relation to smoking drinking and so on is going to have an impact on their health later on in life. You have to get the community and individuals involved in their own health so there is not this huge dependency on the services,” he said before concluding:

“It is very encouraging where you are and where you are heading. You have a hard job in implementing and I think that you are already starting that implementation.”