Northern Ireland

Health and Social Care Board to be abolished by NI minister

The Health and Social Care Board HQ in Belfast
Image caption The Health and Social Care Board is based at its headquarters in Linenhall Street in central Belfast

The health minister's decision to abolish Northern Ireland's Health and Social Care Board has been met with criticism from some politicians and health professionals.

Under Simon Hamilton's plan, all commissioning powers are to be transferred to the Department of Health, while a new group will be established to hold the five health trusts to account.

Ultimately, it means all decisions will be made within the department.

Up until now, the health trusts would have gone to the board to ask for money.

That money would, for example, pay doctors' wages and everything from operations to medical equipment.

Now, the trusts will go straight to the Department of Health, who will hold the purse strings.

The Department of Health will sign the cheque - or commission - the service.

Dr John O'Kelly, chair of the Royal College of General Practitioners NI expressed doubts about the decision.

"Unfortunately the changes which the minister for health has announced today have introduced a further element of uncertainty for general practice," he said.

"It is important that whoever allocates resources is able to ensure value for money, demand quality and are empowered to hold providers to account for this public expenditure," Mr O'Kelly added.

In a letter responding to the decision Kevin McCabe of the NIPSA trade union said it was "absolutely disgraceful that yet again before a holiday period staff are left in a heightened state of anxiety and distress as to where their futures may lie".

Mr McCabe added that "Simon Hamilton's announcement is clearly politically expedient and opportunistic".

SDLP health spokesperson Fearghal McKinney said the minister's decision may be "about changing the plaque on the door as opposed to fundamentally dealing with those problems that are the root causes of failure in the system".

In a statement, the Health and Social Care Board said it was "fully committed to minimising any impact on staff and ensuring that we fully utilise their skills, expertise and commitment moving forward".

It said it was essential that "any new structures and arrangements put in place enhance the health and social care provided for the population of Northern Ireland".

Burdened with bureaucracy

Last November, Health Minister Simon Hamilton hinted strongly that he wanted to restructure the health service.

It followed recommendations from the Donaldson report which highlighted a system burdened with bureaucracy.

In 2014, England's former chief medical officer, Sir Liam Donaldson, was asked to review the performance of Northern Ireland's Department of Health and the health trusts.

Image caption Sir Liam Donaldson previously said the Health and Social Care Board should be done away with as soon as possible

In a tough report that pulled no punches, he recommended that the health service be stripped of bureaucratic structures, with one person taking control.

Off the back of that report, Mr Hamilton launched a consultation.

The outcome is that the health board is to be scrapped with the department taking the lead on the day-to-day running of health and social care services, including planning and monitoring services.

That means the health minister would be ultimately responsible for everything that happens within the health and social care service.

Image caption Simon Hamilton is Stormont's current health minister and may or may not return to the post after the Northern Ireland Assembly elections in May

A new, department-led group, is to be established to ensure trusts meet targets.

The BBC understands that group - the performance directorate - will closely monitor the trusts on targets such as waiting times.

There has been much criticism that no-one was being held to account within the health service when things went wrong, including missed targets and overspent budgets.

In 2015, Nuffield Trust's chief executive, Nigel Edwards, told the BBC that heads would roll in England if waiting lists were on the same scale.

'Changing the name over the door'

While the board is to be scrapped, it is understood its 600 staff are to be redeployed - where exactly is unclear.

Sources said unless there is a real change among those making decisions - this overhaul will be nothing more than just changing the name over the door.

A newly-revamped Public Health Agency will remain in place.

While questions may be asked about the merits of centralising power under one roof - in perhaps his final weeks in the job, Mr Hamilton is leaving a legacy as the minister who finally shook up the health service.

In a statement, a spokesperson for the Department of Health confirmed that the board would cease to exist.

It said by taking "firmer, strategic control of the system" there would be less bureaucracy and the department would be able to react quicker to improving health and social care.

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