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Northern Ireland health review calls for panel of experts to redesign some health facilities Northern Ireland health review says there are too many hospitals
(about 1 hour later)
A review into Northern Ireland's health service recommends an international panel of experts is set up to redesign some health and social care facilities. A review into Northern Ireland's health service has said there are too many hospitals for the 1.8 million population.
The review was led by the former chief medical officer of England, Sir Liam Donaldson.The review was led by the former chief medical officer of England, Sir Liam Donaldson.
He said politicians and the public would have to agree to the plan in advance to allow the health service to move forward.
The review makes a total of 10 recommendations.The review makes a total of 10 recommendations.
Sir Liam was asked to look at just how effectively the Department of Health (NI) and the health trusts have been performing.Sir Liam was asked to look at just how effectively the Department of Health (NI) and the health trusts have been performing.
He has also reviewed the care of patients and management of staff.He has also reviewed the care of patients and management of staff.
Sir Liam said for a population of 1.8 million, there are too many hospitals in Northern Ireland which does not allow for the public to receive the best in health care. He said the fact there are too many hospitals does not allow for the public to receive the best in health care.
Sir Liam said that the Transforming Your Care programme established that elsewhere in the UK, a population of 1.8 million people would likely be served by four acute hospitals - not the 10 that Northern Ireland has.
"Past analysts and observers have pointed to the current level and siting of provision not being in keeping with maintaining high standards of care," the review said.
"Some populations are just too small to warrant full-blown general hospital facilities yet they are kept in place because of public and political pressure.
"Amongst those who work within the system, there is deep frustration that the public are not properly informed about the higher risks of smaller hospitals and that the misapprehension that alternative forms of provision are in some way inferior to a hospital."
Panel of experts
Sir Liam recommends that an international panel of experts is set up to redesign some health and social care facilities.
The far-reaching report concludes that Northern Ireland's health system is no more or less safe than any other part of the UK.The far-reaching report concludes that Northern Ireland's health system is no more or less safe than any other part of the UK.
However, it criticises the implementation of the Transforming Your Care programme, which he said required a "rocket buster" to implement it.However, it criticises the implementation of the Transforming Your Care programme, which he said required a "rocket buster" to implement it.
He also suggested that the Patient and Client Council needed to become independent from the health department in order to best represent the interests of patients.He also suggested that the Patient and Client Council needed to become independent from the health department in order to best represent the interests of patients.
Sir Liam said political pressure and media interest has prevented the salaries of top managers from being raised too substantially.
"The public would be better served if their care system could compete to attract the very best managerial talent," he said.
On the issue of regulation, he recommended that the regulating body the RQIA, could be outsourced so it can make more of an impact.On the issue of regulation, he recommended that the regulating body the RQIA, could be outsourced so it can make more of an impact.
The review was ordered in April last year by the then-health minister, Edwin Poots. The review was ordered in April last year by the then health minister, Edwin Poots.
Sir Liam, once England's most senior doctor, led a team of experts.Sir Liam, once England's most senior doctor, led a team of experts.
His remit included examining whether the health service supports a culture of openness, learning and making amends.His remit included examining whether the health service supports a culture of openness, learning and making amends.
Addressing the assembly, Health Minister Jim Wells said: "There are a number of recommendations that should be progressed and I am determined that this should happen as quickly as possible, particularly those which point to opportunities to improve the quality and safety of our services.
"A key point made by Sir Liam, both in Northern Ireland and the broader UK context, is that the health and social care system we have is not the one we need."
He added: "In light of the challenges posed in the report, we must all contemplate the tough choices to improve health and social care facing the executive. I propose to ask Sir Liam to return next year to advise me on his view of progress made.
"I want to conclude by highlighting another quote from Sir Liam's report: 'The leaders of the Northern Ireland Health and Social Care System should be clear in their ambition, which in our view is realistic, of making Northern Ireland a world leader in the quality and safety of its care. Northern Ireland is the right place for such a transformation, and now is the right time.'"
'Duplication''Duplication'
Last year's major incident at the Royal Victoria Hospital's Emergency department was a turning point in the local health service.Last year's major incident at the Royal Victoria Hospital's Emergency department was a turning point in the local health service.
It highlighted a system in crisis and that intervention was long overdue.It highlighted a system in crisis and that intervention was long overdue.
The regulators, the RQIA, published its own report and recommendations, as did the College of Emergency Medicine.The regulators, the RQIA, published its own report and recommendations, as did the College of Emergency Medicine.
However, what makes this review different from others is that it explores governance issues within the highest helm of the service - the department.However, what makes this review different from others is that it explores governance issues within the highest helm of the service - the department.
It also considers if there is unnecessary duplication between the department, the health board and the public agency.It also considers if there is unnecessary duplication between the department, the health board and the public agency.
Its remit was to investigate if these bodies could be operating more effectively.Its remit was to investigate if these bodies could be operating more effectively.
Some critics would argue that Northern Ireland does not need another review - instead, what is more critical for going forward is strong leadership.Some critics would argue that Northern Ireland does not need another review - instead, what is more critical for going forward is strong leadership.