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Health Minister confirms ambitious plans to restructure Health and Social Care

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Health Minister Simon Hamilton has detailed progress on his ambitious and radical plans for restructuring the HSC.

Following a period of consultation where the Minister outlined a number of reform proposals, there was a clear endorsement for the need to change.

The Minister said: “Last year, I announced my intention to remodel the administrative structures of Health and Social Care in Northern Ireland to make them more streamlined and to reduce complexity. I proposed that:

  • the Health and Social Care Board cease to exist;
  • the Department would take firmer strategic control of the system;
  • Trusts would have more responsibility for the planning of care in their areas and have the operational independence to deliver it; and
  • the Public Health Agency would be retained with a renewed focus on prevention and early intervention.

“The response to the recent consultation is a clear endorsement for the need to change.”

The Minister continued: “While there is broad agreement that our current structures are too complex, too bureaucratic and too slow to support transformation, there is a concern about where responsibility for commissioning of services will reside in the future after the Board is gone.

“I completely understand these concerns. However I am still convinced that we have too many layers of bureaucracy in our system. So, with the objective of eliminating bureaucracy and aiding innovation, I confirm that the Board will go, with system level strategic planning and decision making for the bulk of Health and Social Care services passing to the Department rather than our Trusts. I still want to see our Trusts take on additional responsibility for care in their areas. I want them to have increasing autonomy. And I want them to be held more accountable for what they do.”

The Minister also explained that he intended to further reduce bureaucracy by giving Trusts greater authority to spend their budgets in order to best maximise the impact for their patients and clients.

Minister Hamilton said: “I expect Trusts to be fully accountable for the outcomes that they deliver and to live within the resources that they have. Primary care and the voluntary and community sector play a central and critical role in planning and delivering world class health and social care services, and therefore our re-modelled administrative structures need to enable and underpin the integration which will be so vital in the future.

“I am also convinced that bringing performance management for the Trusts into the Department would help improve lines of accountability. I will therefore press ahead with establishing a Performance Directorate within the Department of Health, to keep our Trusts accountable, ensure they meet the targets we set them and make sure they step forward and take responsibility when performance isn’t as we’d expect.

“There is and will be considerable focus on the future administrative structures of our Health and Social Care system. But the most important people in this process are the patients who will benefit from a streamlined Health and Social Care system. These changes will help us achieve our goal of a world class health and social care system.”

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