8th July 2025
Members will be aware of difficult issues faced by the Belfast H&SC Trust (BHSCT) that have been widely aired over the past few weeks and months across social media, news outlets and in internal Trust communications.
Given the extent of this, and the recent actions of the Health Minister including the apparent sacking the Trust Chair, the Branch is writing to members to update you on some of these issues.
Indefensible behaviours can exist, to some extent or other, in every organisation. If and when they occur, NIPSA’s view is that they should be exposed and addressed directly. Whether they are a symptom of a distressed organisation, or of rotten bullying, the hurt and pain they cause are rejected by NIPSA Branch 730 .
BHSCT, as the biggest health provider in NI, has been rightly called out by the media and Stormont Executive as an exemplar of shortfalls in the broader HSC after a series of high profile public failings. The most recent disclosures, following a protracted investigation into behaviours of some senior staff in the cardio thorassic surgery unit, have once again put the Trust under the spotlight.
The findings of the caridiac surgery investigation report are both shocking and totally unacceptable. As a trade union representing members right across the Trust, at every level, we know poor behaviours do exist, as members regularly contact Branch officers and reps. for advice, support and representation. For too many members, their lived experiences are far removed from the supposed core principles of respect and dignity for all grades of staff that existing policies are supposed to ensure.
However, it is the Branch 730 view, that whilst there undoubtedly can be cultural issues in parts of BHSCT, current media and political interventions only add to a narrative that there is a toxic culture right across the organisation. NIPSA Branch 730 does not believe that to be the case. Poor culture doesn’t develop overnight. It takes years to develop and be normalised. NIPSA believes one of the root causes of the issues in BHSCT, are repeated Department of Health (DOH) failures on funding, combined with unreasonable expectations on service delivery levels and incompetent workforce planning. These are the toxic trio that largely drive poor culture in BHSCT. Both management and trade unions spend much time and effort trying to address the human consequences of this. Too much service delivery being attempted with too few workers, too little money and too much demand for service has repeatedly exposed workers at all levels, in all settings, to scenarios of chronic stress and moral injury. Moral injury that can then find expression in poor cultures within stressed services with unacceptable behaviours displayed by some and associated with poor management responses.
This loop has been associated with the BHSCT since at least 2012, when the then Health Minister Edwin Poots put BHSCT into “special measures”, following serious failings and concerns about how the Trust was delivering some of its services. The warning signs of stress and distress in this organisation have, in NIPSA’s view, been visible ever since.
Current and previous Health Ministers have known about, or should be held to account, for failing to know about, these issues, for years. Despite many warm words and much policy, little has been done to work proactively in addressing early indicators of problematic culture in parts of the BHSCT and indeed the HSC more generally. In truth, when staff across grades and departments have felt under relentless pressure, day after day, to deliver health care, regardless of the human cost of attempting to do so, it can come to as no surprise that working relationships become stressed and completely unacceptable behaviours may be displayed. This is the core problem, in NIPSA’s view, of how a diagnosis is made, without understanding the causes.
Poor behaviour and problematic cultures are repeatedly and effectively challenged by NIPSA alongside our sister trade unions, across those areas of BHSCT, where people management falls short. NIPSA provides services to members who are victims of this poor behaviour, and will take all steps, on members behalf, to ensure that any findings of bullying or cultural shortcomings are rooted out and addressed.
In relation to current issues, the Health Minister appears to have a plan to address these issues in Belfast. It has begun with the ‘sacking’ of a Chairperson, it includes the welcome appointment of a permanent Chief Executive, alongside the insertion of a senior person into the organisation to be ‘his eyes and ears’.
NIPSA does not believe it is credible for DOH officials, or indeed the Health Minister, to claim not to have been aware of the challenges the Trust has been facing for some time. The turnover in senior managers leaving the BHSCT in the last number of years, and what appears to be the lack of challenge to the number of interim appointees in senior positions, has meant the BHSCT has lost experience and continuity of leadership across key services. NIPSA Branch 730 also highlights the apparent growth both in the numbers and costs of legal cases taken both against and by the Trust as evidence of an organisation under very significant pressure.
The fact that the Ministers ‘eyes and ears’ had previously undertaken work in BHSCT when the management problems above where at their most acute, seemingly without feeling the need to alert the DOH to his findings, will not make our members confidence in this new role any easier to build.
The Minister’s loss of confidence in BHSCT Chair, Ciaran Mulgrew, so closely following the open way that the Trust brought the long-running cardiac surgery report to the Assembly, will not make it easier to deal with any future problems openly and transparently. NIPSA also remains at a loss to explain how a ministerial loss of confidence, significant enough to warrant immediate removal, sits beside confidence in the same person chairing the interview process for a new Chief Executive for the Trust as their final act.
Yet, services are still being delivered, many, many people’s lives are being positively transformed, adults and children are still being supported and protected, and lives continue to be saved, because as a Health Service, that’s what HSC staff do.
Thousands of BHSCT NIPSA members come to work every day to deliver a Health Service with vigour and commitment. They deserve to be supported by a Health Minister with a transparent plan that HSC staff and trade unions can buy into. Without this, recent actions risk signalling more of the same, rather than any new start.
Currently, we are unable to say to members if this is for better or worse. However, members can be assured that NIPSA will be progressing these issues over the coming months internally within BHSCT and with the Health Minister himself, and we will update members as this progresses.
In the meantime, if you have an issue, you can contact NIPSA Branch 730 via:
Damien Maguire: 07525669380
Siobhan Bell: 07399777969
Email: nipsa@belfasttrust.hscni.net