Bengoa review: Ambitious health care shake-up unveiled

By Marie-Louise Connolly
BBC News NI Health Correspondent

image copyrightThinkstock
image captionSince 2001, there have been three major reviews of the health service

An ambitious plan to make Northern Ireland's health and social care system fit for the 21st Century has been unveiled.

Health Minister Michelle O'Neill said the 10-year plan would improve a system at "breaking point".

Its 18 time-specific action points are based on recommendations from a government-appointed panel.

Hospital closures are not mentioned, but services will have to meet criteria to prove they are viable, she said.

Opposition politicians have questioned the lack of details in the plan, which is not costed.

'No quick fix'

Northern Ireland's health system had not changed quickly enough to meet the needs of an ageing population, and was unsustainable, Ms O'Neill told MLAs.

"If we continue as we are now, the system in 10 years would need 90% of the entire executive budget."

Analysis: Marie-Louise Connolly, BBC News NI health correspondent

Not one but indeed two reports have made a compelling case for changing how health and social care services are delivered in Northern Ireland.

In stark language, the health minister said the system is at breaking point and that it is not sustainable.

It may be a 10-year vision but short-term fixes in the past have failed.

Her plan sets out a range of priorities, including a focus on keeping people healthy in the first place, and a new model of care involving a team of professionals based around GP surgeries.

The proposals set out in the report, Delivering Together, include:

  • A short-term plan to tackle waiting lists to be drawn up by January
  • By spring, every GP practice will have a named district nurse, health visitor and social worker
  • By December 2016, 54 pharmacists should be in place in GP practices. This roll-out will be completed by March 2021
  • Number of GP training places will increase to 111 - there will be 12 additional places next year and 14 the following
  • More advanced nurse practitioners
  • Further support for looked-after children will be in place by late 2017

On Tuesday evening, the health minister said she was prepared to use the independent sector as a short term measure to tackle hospital waiting lists.

The minister said her plan did not offer "a quick fix".

"This change will be planned, managed, incremental - this is not a "Big Bang," she said.

Meaningful change would require time, money and the support of government, staff and those who use our health and social care services, she added.

Analysis: Chris Buckler, Ireland correspondent, BBC News

This is a report with recommendations. But they are broad in their ideas and their ambitions.

And certainly, at this stage, many are lacking in detail and questions remain on how they will be funded.

image captionThere have been three reports into Northern Ireland's health care service since 2001

First Minister Arlene Foster said the plan represented a challenge the Executive was going to meet head on.

Deputy First Minister Martin McGuinness added that change was required, and "the only question is whether it will happen in a controlled, planned fashion or unfold out of control".

But opposition MLAs criticised the proposals, with Ulster Unionist health spokesperson Jo-Anne Dobson questioning their lack of detail.

The SDLP's Mark H Durkan said a "spectre of doubt" hung over the plans, while TUV leader Jim Allister said they were merely "recycling of a great plethora of fine words".

'Ambitious, and wholly necessary'

A review into Northern Ireland's health service was commissioned in January by Stormont ministers seeking advice on how to improve services, cut waiting lists and care for an aging population.

Professor Rafael Bengoa, chair of the expert panel behind the review, said Northern Ireland faced "a stark choice".

image captionWord cloud of the 87-page Bengoa report

"It can either resist change and see services deteriorate to the point of collapse over time, or embrace transformation and work to create a modern sustainable service," he said.

"Transformation will not be simple, but the panel has no doubt that Northern Ireland has both the people and the energy to deliver a world class health and care system."

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