Two women, Eileen Wilson, 47, and May Kitchen, 77, are taking a joint court challenge against health chiefs in which they will argue the region’s dire waiting lists are unlawful.
The judicial review started at the High Court in Belfast on Tuesday.
The Commissioner for Older People in Northern Ireland Eddie Lynch is represented as an intervenor in Ms Kitchen’s case.
Counsel acting for both applicants said Ms Kitchen needed a cataract operation which could not be provided in a reasonable time and Ms Wilson, who has suspected multiple sclerosis, was first referred to neurology by her GP in June 2017 before getting a consultation by telephone in March 2022.
She has not yet received the results of an MRI scan and has not received treatment yet.
Ms Kitchen went private to get her cataract operation. A year later she was contacted and offered a telephone consultation.
The court heard she was first diagnosed in 2015. She had been caring for her husband who had cancer and later died.
In her affidavit, read to the court, she said she was worried that if her eyesight deteriorated further, she would not be able to be independent and look after herself.
Counsel argued: “These are services which we’re all entitled to, free of charge.”
“She ought not to have been forced to go to a health insurer and one can see from the evidence that had she not done so, she may well still be waiting for surgery,” he said.
“To May Kitchen and others like her, such a condition may not immediately endanger life but risks making life so limited that it feels less worth living.”
He argued the case “essentially applies to everyone in Northern Ireland”, referring to the size of the cohort affected, as reflecting the “situation we are in in terms of waiting lists”.
“This is a problem right across the board, it demonstrates the catastrophic nature of it,” he said.
He said in September 2021 around one in four people in Northern Ireland were waiting either to see a consultant for the first time or receive treatment, an increase of almost 10% since September 2020.
Responding, counsel for the Department of Health said the department would like to make it clear from the outset that it would like everyone in Northern Ireland to receive the very best medical care and for that to happen as quickly as possible.
However he referred to high-level structural types of reform identified by experts as being required for the health service, and the “inescapable conclusion … that those are essentially decisions of a political nature and have to be respected by this court and afforded their proper margin of appreciation”.
“The overarching point here is that there’s a general agreement on the basic circumstances as they pertain in these cases, the matter has been looked into in great detail by experts and it is relatively clear what needs to be done and who needs to do it, but those are not matters that should be troubling this court or reviewed by this court by means of a judicial review application,” he said.
“There are other structures in place long recognised for accountability to be held in relation to that.”
He argued there was a limited scope for the court’s intervention, adding: “There is nothing that the department has done here which is illegal.”
He said Ms Kitchen was assessed, diagnosed and given a place on a waiting list. He also referred to very frequent attendances with her GP and that she received medical support, adding there is no evidence to suggest her case was not progressed in accordance with the assessed medical need.
Ms Wilson was described as being referred by her GP, and the medical assessment by the consultant was that her case was not urgent, which dictated her place on the waiting list.
The case continues.