2012 review: Health stories that made headlines in Northern Ireland
Against the unsurprising backdrop of hospital trolley waits, a shortage of nurses and numerous reviews, this year Northern Ireland's health service took a few unexpected turns. There were sackings of senior health figures, the opening of a new hospital and headlines criticising the fire service.
Scroll back to January, when 2012 began on a tragic note after it emerged that four babies died in neo-natal units from the bacterial infection, pseudomonas. The first death took place in December 2011 in Altnagelvin Hospital in Londonderry, the others a month later at the Royal Victoria Hospital in Belfast. When it first made the headlines the public knew little about the infection, and it soon emerged that neither did some of the health trusts' most senior professionals.
An independent review by Professor Pat Troop concluded that some of the deaths in the pseudomonas outbreak may have been prevented if the Belfast Health Trust had acted more promptly. The review stated that the trust should have declared the outbreak sooner and criticised the lack of communication between health officials, including those in Stormont's Department of Health. While the review highlighted problems and solutions, solicitors for the families are questioning why no-one has been held accountable.
A catalogue of serious incidents, including the pseudomonas outbreak, triggered Health Minister, Edwin Poots, into imposing a series of special measures on the Belfast Health Trust. This meant managers had to account for themselves and their actions to senior officials at the department. The move spoke volumes, suggesting that Mr Poots was far from happy with how the trust was being managed. Indeed, in a shock statement, the minister went as far as saying that heads would roll if trusts did not improve.
And indeed, metaphorically, one head did roll when in December the chair of the Northern Health Trust was sacked. Jim Stewart had been in the post for almost seven years and is the first person in such a position to be removed from post. In an exclusive interview with the BBC, Mr Stewart acknowledged that the health minister did not directly ask him to sack the trust's chief executive, Sean Donaghy. But he said he felt under pressure as the minister had told all chairmen that heads would roll unless targets were met and people were held to account. Mr Stewart said the targets were unrealistic and under those circumstances he could not sack Mr Donaghy.
Lily Kerr, a public face of the health service and trade unions, was sacked from the Health and Social Care Board for emailing documents to journalists and a trade union. Mr Poots, also sacked her as chair of the Northern Ireland Social Care Council. Mrs Kerr said one document was not confidential and that the other had already appeared in the media and was in the hands of trade union officials. Unison has condemned the sacking as "an anti-union move".
The Northern Ireland Fire and Rescue Service (NIFRS) hit the headlines for all the wrong reasons. Despite unapproved bonus payments, unheard grievances, potential fraud and allegations of bullying, no one has been sacked or held accountable. Back in August a document leaked to the BBC described a culture of fear and mistrust prevailing among staff. While that line did not appear in the final report it did question the roles and responsibilities of many individuals.
A BBC investigation revealed that a senior member of NIFRS was allowed to run a private business selling uniforms and other protective equipment at the same time as he was in charge of buying uniforms for the fire service. The officer involved in this outside business was John McGrath. He died in November 2009 and the NIFRS says it is satisfied that there was no conflict of interest involved. The story continues to rumble though - most recently a member of the health committee said the organisation stinks of corruption.
Since Christmas 2011, other alarming stories that hit the headlines were the deaths of two patients in the Royal Victoria Hospital's A&E unit and the admissions ward, before being admitted to wards. The deaths of the man and woman caused a public outcry with immediate calls for extra resources and staff. Whether or not these calls are heeded will be tested in the coming months when hospitals have to cope with the anticipated winter pressures.
It was also a year of leaked documents. In January an email showed managers scrambling for hospital beds across Northern Ireland. The BBC was told that was normal for a weekend in the health service. But if normal, then why the panic and why the long wait for patients? Fast forward 11 months and the BBC learned that the majority of emergency medicine consultants in the Belfast Health Trust wrote to senior management raising concerns about the safety of A&E departments. The Royal's clinical director, Russell McLaughlin, felt so strongly about how services are being run that he stepped aside taking a 20% pay cut.
On the eve of a new year, some stories will undoubtedly remain in the news. The Hyponatraemia Inquiry should end by June 2013 with its chairman, John O'Hara, completing the report into the deaths of five children in hospitals in Northern Ireland.
The outcome of the Northern Ireland abortion debate and the publication of much-awaited guidelines are at the top of the health minister's in-tray, along with a decision on where the children's cardiac services are to be based. There are several options: move the service to England - or create an all-Ireland service.
While the Health Minister, Edwin Poots, remains at the helm the big question is will he still be there in six months? The plan, according to the DUP, is to replace him with Jim Wells. That will be a significant handover with Mr Wells expected to implement some highly unpopular decisions, including those that come about as a result of Transforming Your Care (TYC). For the uninitiated, TYC is the road map for the local health service; a plan that is yet to deliver much.
The next year will see the closure of more wards - an entire hospital would be a step too far for any politician.
There remain more questions than answers. Will the health service be operating seven days a week? After all, people don't get sick from just Monday to Friday. Will the Causeway Hospital's A&E become a minor injuries unit and will the new Downe Hospital in Downpatrick ever be busy?
On a brighter note the opening of the new South West Acute Hospital in Enniskillen is an auspicious beacon in the west - many are hoping its beams will have a knock-on effect elsewhere.