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Simon Hamilton announces 'biggest health system shake-up' in five years Simon Hamilton announces 'biggest health system shake-up' in five years
(34 minutes later)
Stormont Health Minister Simon Hamilton has announced the biggest shake-up in Northern Ireland's health system in five years. The health minister has said he wants to abolish Northern Ireland's health and social care board.
Mr Hamilton has proposed that the Health and Social Care Board be closed. The announcement comes in response to a review of the heath service which recommended a simpler and more efficient system.
He said he believed Northern Ireland no longer needed a standalone organisation like the board. It is the biggest shake-up of how Northern Ireland's health service is run in five years.
The board spends a large part of the health budget identifying needs and acquiring resources and services for the trusts. The board decides where much of the health budget is spent.
"I will retain a Public Health Agency that renews its focus on early intervention and prevention and works more closely alongside the Department in doing this essential work," Mr Hamilton added. But the minister believes future financial decisions can be made by the department and the five health trusts.
Essentially the minister is removing a tier of administration. There will be some voluntary redundancies, while others working in the board will be moved to the department or trusts.
The move is unlikely to make big savings and it will not make any differences to services on the ground, but the aim is to improve efficiency and accountability.
The minister wants the health trusts to be directly answerable to him.
He also plans to set up a panel to advise on more difficult decisions such as reducing the number of acute hospitals and regionalising services.
Mr Hamilton said he would retain a Public Health Agency "that renews its focus on early intervention and prevention and works more closely alongside the department in doing this essential work".
The changes come in response to a review that recommended redesigning Northern Ireland's health system to make it simpler and more efficient.The changes come in response to a review that recommended redesigning Northern Ireland's health system to make it simpler and more efficient.
The review said Northern Ireland had too many hospitals for its 1.8m population.The review said Northern Ireland had too many hospitals for its 1.8m population.
It was published in January by Sir Liam Donaldson, the former Chief Medical Officer for England. It was published in January by Sir Liam Donaldson, the former chief medical officer for England.
It suggested setting up an international panel of experts to redesign the local health system so that expertise is no longer thinly spread.
The report also identified confusion about who was in charge of health care in Northern Ireland.
At present, the Department of Health is responsible for strategy and policy, while below it the Health and Social Care Board is in charge of "commissioning".At present, the Department of Health is responsible for strategy and policy, while below it the Health and Social Care Board is in charge of "commissioning".
The six trusts are then the service providers. The trusts are then the service providers.
The minister wants the trusts to be directly accountable to his department.
The Health and Social Care Board currently employs about 470 people, with an administration budget of £27m.The Health and Social Care Board currently employs about 470 people, with an administration budget of £27m.
"My proposals would mean that many of the Board's existing functions, and staff, would revert back to the department," he said. "My proposals would mean that many of the board's existing functions, and staff, would revert back to the department," Mr Hamilton said.
"Some would move to the new Public Health Agency. Whilst others, especially those in respect of planning for need, will move to our Trusts. "Some would move to the new Public Health Agency. Whilst others, especially those in respect of planning for need, will move to our trusts.
"My vision is for greater operational freedom and flexibility for trusts. This is essential if they are to build on the huge innovative potential of staff across the sector."My vision is for greater operational freedom and flexibility for trusts. This is essential if they are to build on the huge innovative potential of staff across the sector.
"But with greater flexibility comes the need for sharper, and more rapid, accountability.""But with greater flexibility comes the need for sharper, and more rapid, accountability."
The Donaldson review highlighted unnecessary duplication between the department, the health board and the Public Health Agency.The Donaldson review highlighted unnecessary duplication between the department, the health board and the Public Health Agency.
Any move to restructure the management of the health service requires a public consultation and legislation, meaning it is unlikely to come into effect for between 18 months and two years.
Sir Liam suggested that an international panel of experts be established to make some of the tough decisions regarding the future shape of services, including the number of acute hospitals.
The review highlighted that a population of 1.8m could be served by four rather than 10 hospitals.
Sir Liam said it should be agreed in advance to accept whatever proposals such a panel made.
The review also pointed to a report from 2011 called Transforming Your Care which had 99 recommendations.The review also pointed to a report from 2011 called Transforming Your Care which had 99 recommendations.
It focused on moving patient care away from hospitals and into the home or community setting. Any move to restructure the management of the health service requires a public consultation and legislation, meaning it is unlikely to come into effect for between 18 months and two years.
Sir Liam said a time-tabled implementation plan was needed that would include an enhanced role for pharmacists and paramedics.
The fund will be used to pay for cost-saving initiatives developed by the trusts and the implementation of Transforming Your Care.
This announcement by the minister is essentially his answer to the Donaldson report - on the question of who is in charge of the health service, Mr Hamilton says he is.
The minister vows to reduce bureaucracy and he suggests reforming a system so service providers work more closely with the decision makers.