Magee Medical School: The institution waiting to train doctors

It's a long-running medical drama that - should it have a happy ending - could help address a shortfall in doctors and kick-start a region's economy.

Plans for a medical school in Londonderry were first mooted in the mid-2000s, and submitted to the General Medical Council in 2016.

The first students were to start training at Ulster University's Magee campus this year. That hasn't happened.

Plans to recruit for 2020 have now also been shelved.

BBC News NI looks at the story so far.

The Magee campus is on Derry's Northland Road

Why is it needed?

The only medical school in Northern Ireland at present is at Queen's University in Belfast. About 270 doctors graduate each year.

Earlier this year a Department of Health (DoH) commissioned review warned that Northern Ireland needs at least 100 more medical students a year to meet the demand for doctors.

It also warned that expanding student numbers would cost £30m a year.

"The problems we see in our health service have their roots in many reasons," Dr Tom Black of the British Medical Association told BBC News NI.

"One of these is there are simply not enough doctors here to treat all patients that need to be seen.

"Our population is growing and is living longer, and this means we will need more doctors both now and in the future."

A medical student shortfall looms in Northern Ireland according to a report published earlier this year

Why Derry?

The shortage of doctors is particularly acute in the north west. The Western Health and Social Care Trust - which serves a region including Derry - spent £27m on temporary doctors, health professionals, nurses and admin staff during the 2017/18 financial year.

The Western Trust spent £27million on locum staff in the last financial year

Dr Black said doctors are more likely to stay and work in the areas in which they trained.

"A second medical school would help address these workforce gaps and hopefully see the workforce more evenly spread over Northern Ireland."

The expansion of the university in Derry and the opening of a medical training in school in the north west has long been regarded as a catalyst for economic growth in the region. It's a central aspect of the city deal for Derry and Strabane announced in May.

Derry City and Strabane District Council describe it as is "a key catalyst project for the city and region".

And there's a bit of history to its significance.

Derry was overlooked when a site for the new Ulster University was being chosen in the 1960s.

Many feel the expansion of Magee could go some way to addressing the sense of grievance still felt by many in the city.

First-year trainee doctor Kellie would have loved to study closer to home

'I would have loved to study at Magee'

Kellie McClafferty is one of the thousands of students who cross the Irish Sea to study in the UK each year. She's in her first year of medicine at Aberdeen. Her home is just a few miles from Magee.

"I would have loved to stay at home and do my studies but that just wasn't an option.

"Because Queen's is the only option In Northern Ireland, the criteria is so high and with a lot of students competing for a limited number of places, it is so difficult to get into," she said.

"I want to return to the north west, specialise in obstetrics and work at Altnagelvin Hospital. I think studying at Magee would have made that easier."

What has happened so far?

In 2016 Ulster University lodged plans for the school and applied to the General Medical Council (GMC) to train doctors in the north west.

By March 2018 Ulster University was working on a number of recommendations made by the DoH - including how the school would be funded - but Ulster University said the school remained on track.

Prof Louise Dubras was appointed to oversee the delivery of the medical school

In May of the same year, Ulster University appointed Prof Louise Dubras as professor and foundation dean of the school of medicine.

In June 2018 DoH said Ulster University had yet to meet criteria to "demonstrate need and value for money" for a new medical school.

It was in November 2018 that Ulster University vice chancellor Prof Paddy Nixon confirmed the planned 2019 opening could not go ahead because of a lack of devolved government.

Northern Ireland's power-sharing devolved coalition government led by the DUP and Sinn Féin collapsed in January 2017.

Ulster University wanted to welcome the first student intake in 2019

"The only thing that is stopping us from progressing in opening in 2019, 2020 or even 2021 is that simply there is no decision making," Prof Nixon said, in reference to the impasse at Stormont.

A DoH spokesperson at the time confirmed: "The department has made clear publicly and privately that ministerial approval would be needed."

"It is really frustrating, we are ready to go," Prof Dubras told BBC Radio Foyle in February 2019.

Earlier this week Ulster University confirmed it has now abandoned plans to recruit medical students to begin studying there in 2020 because of an absence of a minister.

Is no minster the only concern?

Even if a minister was in sit to sign off the school's business case, concerns over funding have previously been raised.

David Sterling said "we cannot spend money we do not have"

In September of this year the head of Northern Ireland's civil service, David Sterling, wrote to Derry and Strabane District Council.

Mr Sterling said that as the university cannot pay for running the medical school itself "significant ongoing funding will be required from government if this is to proceed" but "we cannot spend money we do not have".

Ulster University says its proposal "requests that the medical school will be fully funded by the NI Executive, through additional student places."

"Recurrent costs for clinical placements, and the two foundation years following the award of a medical qualification by Ulster, have been included within the university's completed business case submitted to the Department of Health," an Ulster University spokesperson told BBC News NI.

What money is available?

The Derry and Strabane city deal, a £105m government funding package to boost the local economy was announced in May. It allocates some of its funding to the medical school.

The city deal is comprised of two parts - £50m to support innovation and grow the area's digital sector.

A further £55m has been allocated to an inclusive future fund for the region. From this fund £30m capital investment has been proposed to help finance the medical school.

But that money is at least a year away and dependent on the return of a Stormont executive.

Can it happen without a local health minister?

Lord Alderdice said he believed the school could be signed off in Westminster

Just weeks ago former Northern Ireland Assembly speaker Lord Alderdice put forward the notion that the Derry medical school may not need Stormont to push ahead.

He believes the medical school could be signed off in Westminster.

Where are we now and what happens next?

On Tuesday Ulster University confirmed plans for the medial school have been postponed again with 2021 now a target for the first intake of students.

"The continued absence of political decision making for NI is a source of significant frustration and is time lost in educating the doctors we urgently need in our hospitals," Prof Paddy Nixon said.

"All other elements of this project have been, and remain, firmly on track. The pivotal funding decision is all that remains, in order to take the next steps," he added.

Professor Nixon told BBC Radio Foyle £5m had been spent to date on the project and warned that the university can't continue to spend on it indefinitely.

Ulster University is currently at stage five of the eight stage GMC accreditation process

DoH reiterated that "we have made it very clear that ministerial approval is needed for this project".

The spokesperson said DoH "will continue to work closely with the university on its proposal".

"It will be the subject of an objective assessment in advance of a ministerial decision," they added.

Furthermore, there are eight accreditation stages for Ulster University to pass before it is granted a licence by the General Medical Council (GMC).

The university is currently at stage five. Ulster University said that stage can only be completed when the GMC recommends progression to stage six.

"That is only possible when a funding decision is confirmed" a university spokesperson said.