The Ulster Unionist Party’s mental health spokesman has struggled to articulate the party’s central health policy during a car crash ten-minute interview this morning.
Lagan Valley MLA Robbie Butler, who was appearing on BBC Radio Ulster’s Nolan Show to represent the UUP in a debate on the future of the NHS in Northern Ireland, repeatedly evaded answering a question about the party’s policy on closing or downgrading smaller hospitals.
The former fire-fighter, who is one of the UUP’s two MLAs on the Assembly’s health scrutiny committee, complained that the report into the future of the NHS in Northern Ireland which the health minister published on Tuesday was “light on detail”.
However, when pressed for even basic detail of the UUP policy, Mr Butler quickly floundered.
Mr Nolan asked the Lagan Valley MLA whether he supported a reduction in the number of acute hospitals, with services centralised in larger hospitals - the key ideological debate among politicians and health experts in Northern Ireland for several years.
Initially, Mr Butler avoided answering the question, saying: “I think the centralisation of acute hospitals is something that has been mooted for many, many years and I think it’s interesting that the minister has thrown the onus on to medical professionals...”
After being reminded that the question was whether the UUP supported centralisation of hospital services, Mr Butler said: “Again, people need to understand the difference between acute hospitals and those for more complex cases. In Lagan Valley, for instance, we lost the 24-hour emergency A&E which was very hard to handle at the time and very hard actually for the people who have that need.”
When asked if he was going to answer the question, the former fire-fighter said: “Yes, yes, absolutely. Absolutely.”
Then, asked the question for a fourth time, Mr Butler said: “I think the answer to that Stephen is that we are in a complex society now where people’s needs are different, so it needs to be looked at on a case by case basis.”
Mr Nolan interjected to say that a decision to centralise services could not be taken on an individual basis.
Asked the question for a fifth time, he said: “The detail for that is down to [sic] the minister to provide...”
Mr Nolan asked the question again, prompting Mr Butler to say: “On the whole, the plan is not there to give an answer to that, Stephen. If the plan was there which shows what those services looked like...”
Mr Nolan interjected again to ask Mr Butler, for the seventh time, to set out the UUP’s position on centralising hospital services. The MLA responded: “It’s all going to come down to affordability as you covered with John Compton...”
Mr Nolan put it to the UUP man that it was not just an issue of affordability - there is a policy decision as to whether centralising services was the right strategy for the NHS.
He asked the MLA for an eighth time if he supported such a strategy. Mr Butler responded: “In some circumstances, there is no doubt that centralising services has benefit, not only financially, but to the patient.”
Mr Butler said that he had proposed centralising mental health services.
Then, asked if he would centralise some A&E units, Mr Butler said: “I think we’ve already seen that...”
When asked if he supported it, he said: “No. No. I think that accident and emergency, as I said to you at the start, is something that...when you are in that emergency situation, the speed of the intervention, the greater the chance of success.”
Former NHS executive John Compton, who five years ago authored a report into the future of the NHS in Northern Ireland, said that in terms of emergency surgery “there is no doubt, clinically and evidentially that if you reorganise those into fewer centres we all do better...it is just irrefutable”.
When asked by Mr Nolan whether the UUP supported centralising those sorts of services, Mr Butler responded that “with regard to stroke services, in 2012 they were finding that they were too fragmented over multiple sites”.
Asked again if he would therefore centralise stroke services, Mr Butler said: “No, no, it wouldn’t be. Absolutely not, no.”
When asked why that was the UUP policy – if the experts say that centralising services will save lives – Mr Butler said: “Stephen, this is more complex than gathering together the combined services and looking at stroke [sic] of itself. It was too fragmented in 2012 between the sites and what I would say is: If it was a plan that we can see ten years down the line but in that time we’ve got the vulnerability, so to get from A to B you need a plan. If the plan was there, then yes, we could support something like that...”
Later in the interview, when it was put to Mr Butler that he had said the UUP opposed centralising services, he said: “No, that is not what I have said...I have not said that we would not centralise the services.”
Mr Butler, who was elected as an MLA in May after serving as a councillor in Lisburn, went on to say “I’m a new politician so this feels a bit like Daniel in the lion’s den..”