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.
More on Data And Forensics
Related Topics:
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.
Advertisement
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.
Please use Chrome browser for a more accessible video player
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.
A week today, Rachel Reeves presents the spending review; how the budget is divided between government departments between 2026 and 2029 – the bulk of this parliament.
It’s a foundational moment for this government – and a key to determining the success of this administration.
The chancellor did boost spending significantly in her first year, and this year there was a modest rise.
However, the uplift to day-to-day spending in the years ahead is more modest – and pared back further in March’s spring statement because of adverse financial conditions.
Plus, where will the £113bn of capital – project – spending go?
So, we’ve done a novel experiment.
We’ve taken Treasury documents, ministerial statements and reports from the Institute for Fiscal Studies.
We put them all into AI – into the deep research function of ChatGPT – and asked it to write the spending review, calculate the winners and losers and work out what goes where, and why.
It comes with a health warning. We’re using experimental technology that is sometimes wrong, and while ChatGPT can access up-to-date data from across the web, it’s only trained on information up to October 2023.
There are no answers because discussions are still going on. Think of it like a polling projection – clues about the big picture as things move underneath.
But, critically, the story it tells tallies with the narrative I’m hearing from inside government too.
The winners? Defence, health and transport, with Angela Rayner’s housing department up as well.
Everywhere else is down, compared with this year’s spending settlement.
The Home Office, justice, culture, and business – facing real terms squeezes from here on in.
The aid budget from the Foreign Office, slashed – the Ministry of Defence the beneficiary. You heard about that this week.
Health – a Labour priority. I heard from sources a settlement of around 3%. This AI model puts it just above.
Transport – a surprise winner. Rachel Reeves thinks this is where her capital budget should go. Projects in the north to help hold voters who live there.
Image: Education Secretary Bridget Phillipson will not be happy with ChatGPT’s suggestion for her department. Pic: PA
Education – down overall. Now this government will protect the schools budget. It will say ‘per pupil’ funding is up. But adult education is at risk. Is this where they find the savings?
So much else – Home Office down, but is that because asylum costs are going down.
Energy – they’re haggling over solar panels versus home insulation.
Justice should get what it wants, I am told. This isn’t about exact percentages. But you can see across lots of departments – things are tight.
Even though Rachel Reeves has already set the budgets for last year and this, and only needs to decide spending allocations from 2026 onwards, the graphs the Treasury will produce next week compare what will be spent to the last set of Tory plans.
This means their graphs will include the big spending increases they made last year – and flatter them more.
They’ll say that’s fair enough, others will disagree. But in the end, will it be enough for public services?
The contest takes place less than a year before the Scottish parliament election, with the result potentially offering a snapshot of how the political landscape north of the border will look in 2026.
Campaigning has been heated, with Reform UK accused of running a “racist” ad on Facebook against Scottish Labour leader Anas Sarwar.
Reform UK leader Nigel Farage has continued to double down, accusing his rival of “sectarian politics”.
More on Conservatives
Related Topics:
In response, the Scottish Labour MSP has branded Mr Farage a “poisonous little man” and “chief clown”, while SNP leader and First Minister John Swinney said: “He poses a threat to our values and must be stopped.”
But who will come out on top following Thursday’s vote?
Here are the candidates vying for support:
Collette Bradley, Scottish Socialist Party
Image: Collette Bradley, Scottish Socialist Party. Pic: Scottish Socialist Party
Scottish Socialist Party candidate Collette Bradley told Sky News that locals she has met while out campaigning have been angry about “poverty, inequality and Labour’s attacks on welfare, our NHS and services”.
She added: “They have little faith in Labour or the SNP delivering change.
“We’ve offered hope with our unique policy of a socialist MSP who’ll remain on the average worker’s wage, keeping us firmly in step with constituents’ living conditions – we alone reject the corrupting influence of the £75,000 MSP salary.
“We’re offering concrete socialist alternatives to the miserable status quo – redistribution of wealth from the millionaires to the millions via progressive taxation.”
Ms Bradley said the party stands for a society built around the “needs of people, not profit”.
She added: “Ordinary lives can be transformed with measures like a £15-an-hour minimum wage; free public transport; and investment in jobs, wages, quality council housing, NHS, education, welfare and pensions.
“We urge voters to reject the continued failure of the political mainstream and be bolder in their demands by voting Scottish Socialist.”
Andy Brady, Scottish Family Party
Image: Andy Brady, Scottish Family Party. Pic: Scottish Family Party
Candidate Andy Brady told Sky News that Scottish Family Party policies and principles are “built upon honesty, integrity and a passion to see real change in our nation”.
He said: “My time spent speaking to the locals over the past several weeks has revealed a common response – people are fed up being let down.”
Mr Brady said there had been “failed promises” to help local businesses, to repair the roads, and to bring life to the town centres and high streets.
He said: “The general feeling is that communities are feeling jaded and frustrated.”
Urging voters to back the Scottish Family Party, he added: “We value the families, businesses and the education of our local communities and if we can support them, communities will flourish.”
Ross Lambie, Reform UK
Image: Ross Lambie, Reform UK. Pic: Reform UK
South Lanarkshire councillor Ross Lambie is hoping to bring Reform UK’s “turquoise tide” to Scotland.
If Mr Farage’s party wins, it will put Scotland’s first minister on notice ahead of Holyrood 2026.
Mr Lambie, who defected from the Scottish Conservatives, told Sky News: “It’s been refreshing spending the past five or so weeks out on the doors in Hamilton, Larkhall and Stonehouse.
“What’s been very clear is that people everywhere are fed up, angry and scunnered with the entire Scottish political establishment.
“They’re fed up with SNP, Tory and Labour lies and are looking for hope.
“Reform UK is offering people a chance of real and radical change by cutting tax, scrapping net zero, ending wokery and fighting for common sense.
“This is now a clear fight between the SNP and Reform – it’s that simple.”
Katy Loudon, Scottish National Party
Image: Katy Loudon, Scottish National Party. Pic: SNP
South Lanarkshire councillor Katy Loudon is hoping to retain the seat for the SNP.
The former teacher told Sky News she had been speaking to people across the region “about what matters to them”.
She said: “People understandably feel let down by Labour.”
Scottish Labour-run South Lanarkshire Council also intends to reduce its school transport provision, which Ms Loudon said will affect thousands of children.
Image: Ms Loudon and SNP leader John Swinney on the campaign trail in Hamilton. Pic: PA
She added: “The Labour Party has lost its way, Farage is on the rise as a result. With an invisible candidate, they’ve totally given up in this by-election.
“Meanwhile, the SNP is focusing on what matters to people and taking action to make things better – with record investment in our NHS, bringing back the winter fuel payment, scrapping peak rail fares and ending Labour’s two-child cap.
“Labour know they can’t win. Only the SNP can beat Farage on 5 June.”
Janice MacKay, UK Independence Party
Image: Janice MacKay, UK Independence Party. Pic: UKIP
UKIP candidate Janice MacKay told Sky News that her party would abolish the Scottish parliament if given the opportunity.
Speaking of “widespread disillusionment” amongst voters, she added: “UKIP offer something different.
“We wish to radically reduce the number of inadequate politicians in Scotland by abolishing altogether the Holyrood parliament.
“It is merely a glorified and expensive form of local authority. To that end, it is unnecessary.”
Ms MacKay believes the nation’s 32 local authorities should be given “strengthened powers”, with Westminster making the “main decisions” affecting the UK.
Ms MacKay added: “Were UKIP to win any seats in the Holyrood talking shop, we should donate 40% of our MSP salary to a Scottish veterans charity.”
Ann McGuinness, Scottish Green Party
Image: Ann McGuinness, Scottish Green Party. Pic: Scottish Green Party
Scottish Green Party candidate Ann McGuinness is the director of a charity which promotes rural connections and champions rural diversity.
The mother-of-two says her own lived experiences of poverty and disability provide her with “valuable insight” into the challenges faced by many whose voices are often unheard in the public discourse.
She has been described by her party as a “dedicated feminist and environmental justice campaigner”.
As well as promoting climate education, Ms McGuinness is also said to have a “strong track record of working across party lines to support women in politics”.
Ms McGuinness said: “Every vote for the Scottish Greens will be a positive vote for a fairer and greener Scotland and a brighter future for Hamilton, Larkhall and Stonehouse.
“If we are to build a truly just and green future, we need to empower every town and village and ensure that no one is left behind.”
Aisha Mir, Scottish Liberal Democrats
Image: Aisha Mir, Scottish Liberal Democrats. Pic: Scottish Liberal Democrats
Scottish Liberal Democrats candidate Aisha Mir told Sky News she has entered politics to “get things done”.
She added: “For too many people, it feels like nothing works anymore.
“The SNP have failed Scotland for 18 years. The Conservatives are lurching to extremes. Labour are already letting people down. Reform have no real solutions.
“I want to be a hard-working local champion who will put your priorities first.”
Ms Mir said her party offers a vision of Scotland “that is back to its best”.
She added: “A Scotland where people can see a GP and an NHS dentist in good time. A Scotland that once again gives our children a world-class education.
“A Scotland with a growing economy and growing businesses, where the government looks after your money and works with our neighbours.
“Vote Scottish Liberal Democrats for a candidate who is focused on what really matters to you.”
Richard Nelson, Scottish Conservative and Unionist Party
Image: Richard Nelson, Scottish Conservative and Unionist Party. Pic: Scottish Conservatives
Scottish Conservatives candidate Richard Nelson told Sky News he got into politics “to make a difference”.
The South Lanarkshire councillor and NHS worker said: “People across this constituency want politicians to be focused on what really matters to them rather than left-wing politicians focusing on their fringe obsessions.”
Image: Mr Nelson with Scottish Tory leader Russell Findlay. Pic: Scottish Conservatives
Mr Nelson said he has seen “first-hand as an NHS employee the damage the SNP have done to the health service during their 18 years in power”.
He added: “My wife disgracefully had to spend 50 hours on a trolley in A&E recently due to the SNP’s neglect of frontline care.
“If people in Hamilton, Larkhall and Stonehouse want to have an MSP who will stand up for those who just want politicians to show some common sense for a change, then you should vote for myself and the Scottish Conservatives on Thursday.”
Davy Russell, Scottish Labour Party
Image: Davy Russell, Scottish Labour Party. Pic: Scottish Labour Party
Scottish Labour candidate Davy Russell told Sky News he has seen “first-hand the damage the SNP has done” to the community after almost two decades in power.
He said: “Throughout this campaign, I have been speaking to people who are feeling abandoned by this SNP government.
“People are languishing on long NHS waiting lists, worried about the state of our schools, and sick of seeing our high streets decline – but this is not as good as it gets.
“The SNP don’t deserve to win here, and the divisive politics of Reform cannot win. This by-election is a straight choice between more of the same SNP failure or a new direction with Scottish Labour.”
Image: Scottish Labour leader Anas Sarwar, left, with Mr Russell. Pic: PA
Mr Russell vowed to “fight tirelessly for the community I love” if he wins.
He added: “I will stand firmly against the downgrading of the Wishaw Neonatal Unit, campaign for an end to SNP cuts to our local services, and demand real action to tackle the crisis in our NHS.
“This is a chance to not only select a local champion for Hamilton, Larkhall and Stonehouse, but to begin to chart a new direction for the whole of Scotland.”
Marc Wilkinson, Independent
Image: Marc Wilkinson, Independent. Pic: Marc Wilkinson
Marc Wilkinson, a pizza shop owner from the Scottish capital, is the leader of the Edinburgh People party.
The businessman is also behind the South Scotland People party, which is part of a bid to establish regional parties across the nation for the Holyrood list vote next year.
Mr Wilkinson’s aim is for “the people of Scotland to choose to vote for themselves”.
Pledging to take instruction directly from the constituents if he were to win the upcoming by-election, he added: “Elect me and you will be my boss. Don’t choose protest. Choose progress.”