Thar she blows that great white myth – a decision!

IT looks like there is a distinct possibility that the rarest of beasts has been spotted in Norn Iron – a real, honest to goodness political decision.

For years, the Captain Ahab’s of the chattering classes and the commentariat have been ploughing through the waters of Hansard and the waves of newsprint in search of a decision.

Finally with Moby Dick like suddenness a decision has crested at the most unlikely of times...

Health Minister Edwin Poots has revealed that one of Belfast’s many accident and emergency departments is to close its doors, and the likely candidate is the Belfast City Hospital’s A&E department.

Belfast currently has more hospitals than you can shake a bandage at, with the Royal, the City and the Mater, not to mention the nearby Ulster Hospital.

In days of yore such a luxury was feasible for a number of reasons. In medical terms the care of emergency patients was not as advanced as it is now, where teams of highly trained nurses, anaesthetists, radiographers and doctors need to be on hand.

Then there was of course the political decision to open the Belfast City Hospital to please some people, not least unionists who claimed that the mile or so to the Royal in west Belfast was to venture into uncharted territories. The Mater was seen as a ‘Roman Catholic’ hospital by some, but that never stopped the injured from the Shankill visiting there when needs arose.

Finally there was the situation of political ennui – there has seemed, for the past decade or so, a political boredom with the idea of health as something that was difficult to make a decision on.

This week Edwin Poots was before the health committee at Stormont – a committee called back from recess, unusually, to discuss real politics rather than spouting off in general.

Minister Poots admitted that there was work needing done, and with staff shortages, and a lack of junior doctors such work involved closing something.

His predecessor, Michael McGimpsey had warned that health was under-funded, but a lack of executive willingness to back a UUP minister made sure it was held in abeyance.

Of course, hot on the heels of Minister Poots’ announcement came the ritual of south Belfast politicians whining on about how they would fight to keep the City Hospital A&E Department and denouncing the decision.

Just like the campaigners for about a dozen small hospitals across the region, they are large on rhetoric and short on solutions. And how many people noticed those closures a year or two down the line? And how many remember that those hospitals once provided A&E services.

What Minister Poots needs to do now is to make the closure fact in order to trim the fat away from other hospitals, the Mater being surely next in the firing line, and to invest any savings into making the Royal Hospital’s A&E departments (for there is also the regional children’s A&E unit on the same site) truly world beaters where patient’s care is the best that it can be.

After that he just has his own constituents' complaints about shorter A&E hours at Lagan Valley Hospital to worry about!

FOOTNOTE: Yes, you could argue that Minister Poots’ announcements that Altnagelvin Radiotherapy unit would go ahead was a decision, but for the sake of an extended metaphor we prefer to see it as keeping an election promise that the First and Deputy First Minister made...