Northern Ireland's health and social care commissioner met with older people's groups last summer and surveyed their priorities. Participants expressed deep concerns about service availability, including a sense of vulnerability. They indicated that universal health provision appears to be declining.

The commissioner noted evidence supporting perceptions of reduced accessibility. Older people described calling up to 100 times for GP appointments, leading to anxiety and stress. One individual reported needing to call three or four hundred times, only to find no slots available.

Northern Ireland now has 100,000 more people aged 65 and over than a decade ago. At the same time, GP numbers have fallen, along with social care packages and care home beds. Waiting lists have grown longer.

Dr Alan Stout, chair of the British Medical Association's Northern Ireland Council, attributed issues to years of underfunding. He stated that many practices use telephone triage to cope with demand and called the situation not sustainable.

The BMA reports rising patient demand for GP appointments alongside unemployed trained GPs unable to secure positions due to funding shortages. Dr Cheska Ball, co-chair of the BMA's GP registrars committee, described this as a crisis, with some colleagues leaving general practice.

Dr Mark Steggles, BMA sessional GPs chair, said the unemployment issue persists and worsens. He noted GPs considering work abroad, such as in Canada. The BMA calls for ring-fenced funding directly to practices and a strategy to retain GPs.

The commissioner linked core problems to demographic ageing, with growing numbers of older people increasing service demand while the working-age population shrinks. She advocated a whole-government response.