Can reforming the operating model help Northern Ireland out of its healthcare crisis?

Northern Ireland has been without a fully functioning devolved government since February 2022, when the Democratic Unionist Party collapsed the Stormont Executive government in a protest over the post-Brexit protocol agreement. Without an operational government, the region has languished in limbo under deeply unsatisfactory indirect rule, somewhere between being directly ruled by the UK and devolution of powers to Northern Ireland. Under this model of governance, senior civil servants are “keeping the lights on” but have extremely limited agency to make decisions.1Twenty five years after devolution was reintroduced in Northern Ireland, we must accept that this unstable power sharing model, which has been in a state of collapse for 40% of its existence, has been catastrophic for the healthcare system.2 Despite higher levels of spending per capita on healthcare than other UK regions, outcomes in Northern Ireland are by far the poorest and there is no meaningful plan or strategy…
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