We can’t hope to see a reformed health service if we continue to be parochial in our way of thinking.

Our health service, in the words of BBC health correspondent Marie-Louise Connelly, is hanging by a thread and it is only doing so because of the dedication of the staff right across all sectors.

It’s all very well looking and demanding local services, but if it does not fit into an overall frame work, efficiency will not be achieved.

Back in 2016, the then Health Minister in the Northern Ireland Executive, Michelle O’Neill, launched the latest review of our health service – a report to follow a few more that are resting on shelves somewhere on the Stormont estate.

It has not been acted upon for very obvious reasons.

One has to welcome the appointment of the new Health Minister in Robin Swan MLA.

He has a track record that would suggest confidence that, given the tools, we may be able to see major change to the way our health service is run.

All parties welcomed the Bengoa Report; it was accepted and acclaimed as the way forward for our health service.

In Bengoa, he recommended systems, not structures.

We are still at the point of collapse in our service. The message then was change or we face collapse.

This is why I say we have to have a change of mind-set with the way we treat our health service.

This has to be how we use our local surgeries, our hospitals. We cannot continue to abuse what we have.

As an example of what I’m trying to illustrate, take appointments – let them be to your GP, or consultant in a hospital.

Why is it the case that whether it be the local surgery or the hospital, there are so many missed appointments?

Waiting times have increased so much this past decade. The number to September last was up on 430,000 people waiting on a first consultant-led appointment.

Again, we cannot have a change quick enough to address the urgent needs of the people on this list.

Also, when dealing with the local GP surgery, why do we have to request prescriptions for medication that we can get over the counter at a minute fraction of the cost to our health budget, if it is provided on prescription?

There is not an infinite amount of money to fund this sort of abuse of the system.

We all have a part to play if we are to succeed in the future.

To speak of our situation locally, we have in many ways a ‘white elephant’ of a local hospital, the South West Acute Hospital (SWAH), something that promised so much but has delivered much less.

It was a project that did not see enough scrutiny at the time of its proposal, ie, it was a PFI – a Private Financial Initiative.

This has meant we have a hospital that is costing the health service millions more than it should really have been.

The original building cost was in the region of £250million when it was built in 2012.

A report in 2022 stated that the Trust owes the private sector nearly £600million.

Why has this situation been allowed to develop to this extent? Can this not be addressed and major savings achieved?

The Western Trust that controls affairs in this area has a history of failing to provide and properly administer on services in our area.

Time and time again, those in charge have failed to be up to the job.

We have had numerous areas where the patients and their families have been treated very poorly – an example of this is the disability learning fiasco.

This was an area going back many decades where individuals and their families were discriminated against and were denied proper support and benefits.

This has still not been properly addressed.

Back in 2016 I, along with my SDLP MLA colleagues, met with the Trust in Derry to try and move the situation on and get the people concerned their proper benefits.

Now, with politics on stream again, this situation – like many others – requires to be addressed sooner rather than later.

The present Board of the Trust has been heavily laden with reps from the Derry side of the district.

This is not a fair way to represent an area; this needs to be addressed in order to create a fair representation for the whole area.

Back to our SWAH (to finish this week’s contribution), where services have been under scrutiny over this past few years, and where with emergency surgery being discontinued 12 months passed in November, it has to be said, on a number of occasions recently, the question, “Has it been missed from the suspension was introduced?” has been asked.

I do believe we will not see a return of emergency surgery to the SWAH, and the recent decision regarding Daisy Hill in Newry, which also had its emergency surgery suspended, has now been made permanent.

I believe we will see the same decision made with the SWAH.

As part of Bengoa, we have to hope that the investment in bricks and mortar back in 2012 in the SWAH – for the facilities and services to be available in the future – will ensure that the people across the North have a health service that is based on getting the best care possible, when needed.

In order to have this, we cannot see the radical overhaul of the set-up soon enough.

Richie McPhillips is a former SDLP MLA for Fermanagh and South Tyrone.