NEWS
Minister announces ‘Radical’ changes to local healthcare delivery
As Pharmacy in Focus was going to press, Minister for Health Simon Hamilton announced a radical shake up of changes to healthcare delivery in Northern Ireland.
His statement encompassed a proposal to close down the Health and Social Care Board and ruling out recommendation 1 in Sir Liam Donaldson’s report that an international panel of experts be appointed to decide on the number of hospitals needed in Northern Ireland.
The Minister made his comments at a Leadership Conference in Ballymena to an audience of over 200 senior health service staff.
"Since its establishment, the people of the United Kingdom have cherished the Health Service and the core principles it was founded upon. Those core principles are, I believe, facing their biggest test in the 60+ year history of the NHS. There is a real risk that if we fail to acknowledge, address and answer the multiple challenges that are before us, future generations will not have a Health Service like the one we did. They will instead inherit something far removed from the Health Service we know and love,” he added.
"From conversations I have had with clinicians it is clear that many feel that our commissioning system doesn’t work, they don’t understand it and, worst of all, it actually inhibits innovation. Our commissioning system isn’t as effective as we need it to be. Whether this is because of shortcomings in the model or in its implementation is immaterial.
"We have too many layers in our system. I want to see the Department take firmer, strategic control of our Health and Social Care system with our Trusts responsible for the planning of care in their areas and the operational independence to deliver it.
An End to Commissioning What the Health Minister outlined he was signalling, is an end to the current way we commission healthcare in Northern Ireland.
“It has not worked and arguably is never going to work well in a small region like ours,” he said as he confirmed his proposal to close down the Health and Social Care Board. “This is about structures, not people. The Board has many talented people working within it, doing many important things to a very high standard. But the administrative structures created during the last
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Assembly term do not serve us well especially as they blur the lines of accountability and weaken authority.
"I will retain a Public Health Agency that renews its focus on early intervention and prevention. I will ensure a much greater focus within the Department on the financial and performance management of the Trusts through the creation of a specific directorate within the Department."
No Outsider Decision Making In response to recommendation 1 in Sir Liam Donaldson’s Report the Minister said, "I am not in public service to hand over lock, stock and barrel, the future of Health and Social Care in Northern Ireland entirely to outsiders to take decisions without any democratic fail safe or local input. “I will therefore be appointing a panel to lead the debate on the best configuration of Health and Social Care services in Northern Ireland which will draw on the experience of people working in Northern Ireland, but use international expertise as appropriate.
"I want a clinically led conversation to advise us what the services the people of Northern Ireland should expect from their Health and Social Care system.
"I have spoken before of my view that the biggest barrier to reforming our Health and Social Care sector isn’t the view of the public or our staff or even resources. It is the reticence of our politicians to take the tough decisions. To make the big calls. To set aside party differences and do what is ultimately right for the standard and safety of care our people receive.
"It is my intention to convene a summit involving the other parties to allow others to input their ideas, suggest their solutions and, I hope, collectively reach agreement on a shared vision for the future of Health and Social Care in Northern Ireland."
Minister Hamilton added, "I will pursue a significant increase in Health spending on Northern Ireland in the next Budget. I want to take a sizeable amount of any additional funding my Department receives as part of the Budget process and earmark it specifically for a Health and Social Care Transformation Fund.
"We will find out if other parties have the resolve for reform or if it was all just rhetoric. By being bold and by being brave I believe that we have the ability within Northern Ireland’s Health
and Social Care system to not just see off this existential threat but also build that world class service that our citizens deserve."
The Northern Ireland Confederation of Health and Social Care (NICON) welcomed the Minister’s Statement. Colm McKenna, Chairman of NICON explains, “While much progress has already been made in reforming and modernising our system, our members are agreed that more needs to be done – we just need to get on and do it. These announcements today will give impetus, as well as shape and direction to change.
“NICON members specifically welcome the focus on reconfiguring our services and underpinning funding to do it. The way forward has been known by experts for many years. We look forward to seeing how the proposed expert panel, involving clinicians, will work. We await with interest details on the suggested political summit – this suggestion aligns with our members call on politicians for collective political leadership. In reality it is the only way this level of change can be successful”.
Speaking about the reallocation of the tasks of the HSC Board, Colm said “We all recognise the need to reduce bureaucracy and provide clear accountability structures. We need to better understand how this shift will support innovation and allow all our
organisations to be more flexible, collaborative and agile to deliver the best care possible. The Minister is right, we have very talented and committed people and we need to make sure colleagues and our partners can work in the most effective ways possible to deliver the best outcomes for the population of Northern Ireland”.
The UCA welcomes the Health Minister’s announcement that he is to radically overhaul our Health & Social Care system. The need to transform has been recognised by all with the publication of Transforming your Care and everyone agreed it just needed to be delivered.
Plans to underpin the transformation with dedicated funding is particularly welcome as this was a major flaw in Transforming your Care. The call for political consensus is refreshing and is the right approach to take to ensure transformation is delivered.
Killian Johnston, UCA President & ICP Pharmacist “Recognition that commissioners should work closely with local primary care practitioners is a validation of the sterling work undertaken by ICPs. Community pharmacy will continue to represent the profession in this arena working alongside GP colleagues in improving and developing health services in our localities.”
Minister for Health Simon Hamilton
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