Without political input, many important decisions on budgets and public sector pay have been impossible to pass.
Successive suspensions at Stormont over the years have contributed to long-term issues in the public sector, with impacts seen across all areas of public services.
But perhaps nowhere more so than in the health and social care sector.
There are over 420,000 people currently waiting for their first consultant-led outpatient appointment following referral, an increase of more than fivefold since 2008.
While some individuals may appear on the list more than once awaiting separate treatments, this is still a huge figure in a population of 1.9 million.
In the latest available figures to the end of September, half of these had been waiting for more than a year to see a consultant, up from 5% in June 2015.
And nearly one in three patients had been waiting for more than two years for their initial consultation, up from 0.1% in September 2015.
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Health and Social Care Northern Ireland’s figures are not directly comparable with NHS England, which uses a different measure (from referral to treatment rather than to first appointment).
However, as a broad comparison, while waiting times have also been poor in England in November, only 4.7% had been waiting more than a year to complete their entire treatment journey following initial referral and less than 0.01% for more than two years.
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Meadbhba Monaghan, chief executive of the Patient and Client Council (PCC), told Sky News:“The issues facing Health and Social Care (HSC) services in Northern Ireland are significant and varied; they have been building over a long period of time, and will not be fixed overnight.
“Through our work in supporting the public, we can clearly see many people are concerned about how they are communicated with, and how they experience services. This includes the quality of care they are receiving and how long they have to wait to access that care.
“Our physical and mental health is fundamental to our wellbeing, the current pressures on the HSC system and staff will be having a negative impact on individuals and their families.”
What has happened in the political vacuum
The devolved government has been suspended on five other occasions since it first sat in 1999 following the Good Friday peace agreement, with the longest suspension lasting for four-and-a-half years between October 2002 and May 2007.
However, in the context of post-pandemic recovery and an unprecedented cost of living crisis, the recent suspension has been “vastly more difficult”, according to recently retired senior civil servant Andrew McCormick.
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2:41
Stormont deal divides MPs
The former director general of international relations in the Executive Office and ex-permanent secretary at the Department for the Economy told Sky News: “Civil servants can make some routine decisions to keep things going as best they can, but it’s very limited.
“I know that my former colleagues have found it incredibly, incredibly difficult this last couple of years, with the cost of living and inflation making the situation much more fraught [than the last suspension of 2017-2020].
“It’s been a ridiculous position to be in and a complete abdication of responsibility.”
In the absence of ministers in Stormont, the Westminster parliament can still pass legislation and have taken responsibility for budgets and other ad hoc areas of legislation.
In the past two years, departmental budgets have plateaued despite exceptionally high levels of inflation.
And there has been a vacuum in which civil servants cannot take day-to-day decisions which are political in nature.
This includes coming to public sector pay deals because any commitments would take departments over current budgets.
Public sector pay
Last month saw one of the biggest strikes in Northern Ireland’s history, with an estimated 150,000 public sector workers joining marches and picket lines across the country to demand a resolution to pay disputes.
Median pay for public sector workers in the UK as a whole increased by 20% from £30,540 to £36,708 between 2016 and 2023. In Northern Ireland, pay has increased at a slower rate of 16.1% over the same period from £31,570 to £36,651 and is now below the UK average.
In its latest employee earnings report, the Department for the Economy noted real earnings in the public sector fell by 7.2% in the year to 2023, compared with an increase of 1.4% in the private sector.
Carmel Gates, general secretary of Northern Ireland’s largest public sector union NIPSA, which has around 45,000 members, told Sky News: “Quite frankly, what we are witnessing is haemorrhaging of public servants out of Northern Ireland, either to different parts of these islands where they’re better paid or to further abroad.
“It isn’t just in the last two years that the problems emerge, Northern Ireland has been underfunded for quite a period of time.
“The strikes on 18 September is the most galvanised and unified the trade union movement here has been probably ever and involved almost all public service unions.”
After many years of disruption over Brexit, COVID, the cost of living crisis, and prolonged periods without governance, many are hoping for swift and decisive action from the newly resumed executive in the coming days to stabilise the situation in Northern Ireland.
“When they get back they will need to set a budget very quickly, and that will help a lot in the short term,” says Andrew McCormick.
“They then have to face up to the longer-term issues. Much more needs to be done on stabilising public services.”
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
Lib Dems don’t tend to listen to right-wing podcasts.
But if they did, they may be heartened by some of what they hear.
Take the interview Kemi Badenoch gave to the TRIGGERnometry show in February.
Ten minutes into the episode, one of the hosts recounts a conversation with a Tory MP who said the party lost the last election to the Lib Dems because they went too far to the right.
Everyone laughs.
Then in March, in a conversation with the Canadian psychologist Jordan Peterson, the Tory leader was asked to describe a Liberal Democrat.
“Somebody who is good at fixing their church roof,” said Ms Badenoch.
She meant it as a negative.
Lib Dems now mention it every time you go near any of them with a TV camera.
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4:12
‘It’s a two-horse race!’
The pitch is clear, the stunts are naff
At times, party figures seem somewhat astonished the Tories don’t view them as more of a threat, given they were beaten by them in swathes of their traditional heartlands last year.
Going forward, the pitch is clear.
Sir Ed Davey wants to replace the Tories as the party of middle England.
Image: Sir Ed rides on a rollercoaster. Pic: PA
One way he’s trying to do that is through somewhat naff and very much twee campaign stunts.
To open this local election race, the Lib Dem leader straddled a hobbyhorse and galloped through a blue fence.
More recently, he’s brandished a sausage, hopped aboard a rollercoaster and planted wildflowers.
Senior Lib Dems say they are “constantly asking” whether this is the correct strategy, especially given the hardship being faced by many in the country.
They maintain it is helping get their message out though, according to the evidence they have.
“I think you can take the issues that matter to voters seriously while not taking yourself too seriously, and I also think it’s a way of engaging people who are turned off by politics,” said Sir Ed.
Image: Sir Ed on a hobby horse during the launch of the party’s local election campaign in the Walled Garden of Badgemore Park in Henley-on-Thames. Pic: PA
Pic: PA
‘What if people don’t want grown-ups?’
In that way, the Lib Dems are fishing in a similar pool of voters to Reform UK, albeit from the other side of the water’s edge.
Indeed, talk to Lib Dem MPs, and they say while some Reform supporters they meet would never vote for a party with the word “liberal” in its name, others are motivated more by generalised anger than any traditional political ideology.
These people, the MPs say, can be persuaded.
But this group also shows a broader risk to the Lib Dem approach.
Put simply, are they simply too nice for the fractured times we live in?
“The Lib Dems want to be the grown-ups in the room,” says Joe Twyman, director of Delta Poll.
“We like to think that the grown-ups in the room will be rewarded… but what if people don’t want grown-ups in the room, what if people want kids shitting on the floor.”
Image: Sir Ed canoeing in the River Severn in Shrewsbury, Shropshire. Pic: PA
A plan that looks different to the status quo
The party’s answer to this is that they are alive to the trap Lib Dems have walked into in the past of adopting a technocratic tone and blandly telling the public every issue is a “bit more complicated” than it seems.
One senior figure says the Lib Dems are trying to do something quite unusual for a progressive centre-left party in making a broader emotional argument about why the public should pick them.
This source says that approach runs through the stunts but also through the focus on care and the party leader’s personal connection to the issue.
Presenting a plan that looks different to the status quo is another way to try to stand apart.
It’s why there has been a focus on attacking Donald Trump and talking up the EU recently, two areas left unoccupied by the main parties.
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1:09
‘A snivelling cretin’: Your response?
The focus on local campaigning
But beyond the national strategy, Lib Dems believe it’s their local campaigning that really reaps rewards.
In the run-up to the last election, several more regional press officers were recruited.
Many stories pumped out by the media office now have a focus on data that can be broken down to a constituency level and given to local news outlets.
Party sources say there has also been a concerted attempt to get away from the cliche of the Lib Dems constantly calling for parliament to be recalled.
“They beat us to it,” said one staffer of the recent recall to debate British Steel.
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1:08
Steel might have been ‘under orders’ from China
‘Gail’s bakery rule’
This focus on the local is helped by the fact many Lib Dem constituencies now look somewhat similar.
That was evidenced by the apparent “Gail’s bakery rule” last year, in which any constituency with a branch of the upmarket pastry purveyor had activists heaped on it.
The similarities have helped the Lib Dems get away from another cliche – that of the somewhat opportunist targeting of different areas with very different messages.
“There is a certain consistency in where we won that helps explain that higher vote retention,” said Lib Dem president Lord Pack.
“Look at leaflets in different constituencies [last year] and they were much more consistent than previous elections… the messages are fundamentally the same in a way that was not always the case in the past.”
Image: Sir Ed in a swan pedalo on Bude Canal in Cornwall. Pic: PA
A bottom-up campaign machine
New MPs have also been tasked with demonstrating delivery and focusing doggedly on the issues that matter to their constituents.
One Home Counties MP says he wants to be able to send out leaflets by 2027, saying “everyone in this constituency knows someone who has been helped by their local Lib Dem”.
In the run-up to last year’s vote, strategists gave the example of the Lib Dem candidate who was invited to a local ribbon-cutting ceremony in place of the sitting Tory MP as proof of how the party can ingratiate itself into communities.
With that in mind, the aim for these local elections is to pick up councillors in the places the party now has new MPs, allowing them to dig in further and keep building a bottom-up campaign machine.
‘Anyone but Labour or Conservative’
But what of the next general election?
Senior Lib Dems are confident of holding their current 72 seats.
They also point to the fact 20 of their 27 second-place finishes currently have a Conservative MP.
Those will be the main focus, along with the 43 seats in which they finished third.
There’s also an acronym brewing to describe the approach – ABLOC or “Anyone but Labour or Conservative”.
Image: Keir Starmer and Kemi Badenoch aren’t exactly flying high in the opinion polls
9% swing could make Sir Ed leader of the opposition
The hope is for the political forces to align and Reform UK to continue splitting the Tory vote while unpopularity with the Labour government and Conservative opposition triggers some to jump ship.
A recent pamphlet by Lord Pack showed if the Tories did not make progress against the other parties, just 25 gains from them by the Lib Dems – the equivalent of a 9% swing – would be enough to make Sir Ed leader of the opposition.
What’s more, a majority of these seats would be in the South East and South West, where the party has already picked up big wins.
As for the overall aim of all this, Lord Pack is candid the Lib Dems shouldn’t view a hung parliament as the best way to achieve the big prize of electoral reform because they almost always end badly for the smaller party.
Instead, the Lib Dem president suggests the potential fragmentation of politics could bring electoral reform closer in a more natural way.
“What percentage share of the vote is the most popular party going to get at the next general election, it’s quite plausible that that will be under 30%. Our political system can’t cope with that sort of world,” he said.
Whether Ms Badenoch will still be laughing then remains to be seen.
This is part of a series of local election previews with the five major parties. All five have been invited to take part.
It would be “foolish” to stop engaging with China, the chancellor has said, as Sir Keir Starmer held his first call with Donald Trump since he put 10% tariffs on goods imported from the UK.
Rachel Reeves will hold talks with the US next week amid efforts to establish a trade deal, which the government hopes will take the sting out of the president’s tariffs.
There has been speculation Washington may press the government to limit its dealings with China as part of that deal, having launched a tit-for-tat trade war with its economic rival.
But Ms Reeves told The Daily Telegraph:”China is the second-biggest economy in the world, and it would be, I think, very foolish, to not engage.
“That’s the approach of this government.”
She suggested she would back the fast fashion firm Shein launching an initial public offering (IPO) in the UK, saying the London Stock Exchange and Financial Conduct Authority have “very strict standards” and “we do want to welcome new listings”.
Shein, which was founded in China but is now based in Singapore, has faced several obstacles to its efforts to float, including UK political pressure over alleged supply chain and labour abuses.
Image: Sir Keir Starmer and Donald Trump met in February. Pic: PA
‘Productive discussions’
When it comes to a UK-US deal, The Daily Telegraph has reported officials in Washington believe an agreement could be weeks away.
But on Thursday, Mr Trump said he was in “no rush” to reach any deals because of the revenues his new tariffs are generating.
During Sir Keir’s call with the US president on Friday, the two leaders talked about the “ongoing and productive discussions” on trade between the two nations, according to a Downing Street spokesperson.
“The prime minister reiterated his commitment to free and open trade and the importance of protecting the national interest,” Number 10 said.
As well as the 10% levy on all goods imported to America from the UK, Mr Trump enacted a 25% levy on car imports.
The health secretary is taking inspiration from Japan in his bid to change how Britons are treated by the NHS.
Wes Streeting has said he’s interested in the idea of “health MOTs” for Britain’s older citizens, evoking how the Asian island nation relies on personalised medical plans for its ageing population.
Japan combines genomics and AI machine learning to offer hyper-bespoke programmes for individuals, helping to predict and prevent illnesses before they really take hold.
Mr Streeting said such an approach could be a “game-changer” in the UK, as he prepares to publish his 10-year plan for the health service later in 2025.
He has repeatedly spoken about his desire to move more of the NHS’s work out of hospitals and into local communities, focusing more on preventative care than more expensive and invasive emergency treatment.
Last year, NHS England – which is due to be scrapped – announced patients over 65 or those with frailty-related conditions would be given health MOTs outside emergency departments to avoid unnecessary admissions.
The tests checked for blood pressure, heart health and mobility.
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3:05
Why has Starmer axed NHS England?
‘A lot of opportunity’
Speaking to The Telegraph, the minister said Japan was an “interesting” case study to follow because it’s got a “very significant ageing society”.
Japan’s population has been shrinking and growing older for decades as young people delay marriage and having children largely due to unstable jobs and economic difficulties.
Mr Streeting has reportedly been briefed by an ex-Japanese health official about the country’s health programmes.
He told The Telegraph while the NHS faced “enormous challenges”, he believed advances in technology – notably around artificial intelligence – offered “a lot of opportunity and hope”.
He said he hoped personalised programmes like Japan’s could eventually be offered to everyone in the UK.