The Performance of the Health Service in Northern Ireland

A report published today by John Dowdall CB, the Comptroller and Auditor General, shows that the health service is making good progress against many of the Department of Health, Social Services and Public Safety’s (DHSSPS) key targets. For example, fewer people are dying from common conditions such as cancer and coronary heart disease and patients are waiting less time for treatments and appointments in hospital. At the same time, however, the Northern Ireland Audit Office report shows that public health issues such as obesity and suicide continue to need attention as does the issue of health inequality.

Health Improvement

Life Expectancy - there has been a positive change in the life expectancy of the population: for males this increased from 69.2 years in 1981 to 76.1 years in 2005 and for women from 75.5 years to 81 years. However, progress on DHSSPS’s target to halve the gap in the life expectancy of those in more deprived areas and the Northern Ireland average by 2012 has not been so encouraging. By 2005, the gap for men had reduced only slightly from 3.9 years to 3.7 years and for women from 2.7 to 2.5 years.

Smoking – smokers currently make up 23 per cent of adults, having fallen from around 30 per cent in 1996-97. The Department’s target for 2011 is 22 per cent. At the same time, smoking continues to be relatively common among semi-skilled and unskilled manual workers. Their prevalence is now 30 per cent having fallen from 33 per cent in 2006-07. The target is to get this down to 27 per cent by 2011.

Obesity: The Department has a target to stop the increase in levels of obesity in children by 2010. Recent data show that the level of obesity among Primary 1 children had declined slightly since 2003-04 from 5.7 per cent to a still high 5.1 per cent in 2005-06. The proportion of obese children is a serious concern for the health service as obesity reduces life expectancy and increases the risk of a wide range of medical conditions.

Suicide – After a marked year-on-year increase in registered deaths from suicide, the latest available figures show a decrease to 242 in 2006 from 291 the previous year. However, it is too early to determine whether the reduction points to a longer downward trend or that it will meet the Department’s 10 per cent reduction target by 2008. The Audit Office report shows that the rate of suicide is more than three times higher for men than women; almost twice as high in deprived areas; and around 20 per cent higher in urban areas compared with rural areas. North and West Belfast have suicide rates of almost twice the Northern Ireland average.

Teenage Births – between 1999 and 2006 there was a 20 per cent reduction in unplanned births for teenage mothers. In comparative terms, Northern Ireland had a teenage birth rate 17 per cent lower than the overall United Kingdom figure for 2005.

Oral Health - While there have been improvements in the oral health of the population as a whole, there has been little improvement in disease levels over the past 10 years in children under five. Moreover, children living in the 20 per cent most deprived wards in Northern Ireland are almost twice as likely to have dental decay as children from the 20 per cent most affluent wards.

Improving Clinical Outcomes

Circulatory Disease - the death rate from circulatory diseases in Northern Ireland has decreased by 28 per cent between 2000 and 2006. The DHSSPS target of a 20 per cent reduction by 2010 has, therefore, already been well exceeded.

Coronary Heart Disease – Northern Ireland has shown the greatest reduction in coronary heart disease for both men and women in the United Kingdom. However, research has also shown that electoral wards in with the highest death rates from coronary heart disease are also those with the highest levels of deprivation.

Stroke – Northern Ireland has the lowest death rate from stroke in the United Kingdom.

Cancer – Using 1993-94 as a baseline, the five-year survival rate for the "main" cancers has been improved by five per cent in line with the DHSSPS target.

Renal Services – all renal patients needing dialysis services are receiving them.

Waiting for Care

Inpatients, Day Cases - patients wait no more than six months for any inpatient or day case treatment. Only 56 patients were waiting more than 21 weeks for treatment at the end of March 2008.

Outpatients – patients wait no more than six months for a first outpatient appointment. Only 59 outpatients were waiting more than 13 weeks for a first appointment at the end of March 2008.

GP Appointments - On the basis of available statistics it is likely that all primary care appointments will be met within the targeted 48 hours by March 2008.

Ambulance response times - The Northern Ireland Ambulance Service Trust responds to 70 per cent of life-threatening calls within eight minutes. The Department is working with the Trust to enable it to achieve the national response target of 75 per cent of life-threatening calls within 8 minutes by 2011.