News / Hamilton backs plans for NI structural reforms

Following a consultation, he acknowledged there was concern about future responsibility for commissioning – only 24% of respondents agreed trusts were best placed to assess local needs and should be given greater responsibility for planning local services.

More than 60% of respondents said the proposed changes would not streamline and simplify the health and care system. The Department of Health, Social Services and Public Safety acknowledged there was insufficient detail in the consultation for respondents to come to an informed opinion and promised further stakeholder engagement. Almost nine in 10 respondents agreed that a full competitive commissioning system was too complex and transactional for an area as small as Northern Ireland.

Mr Hamilton (pictured) believed the response to the consultation – which backed reducing complexity in the system, support for innovation and performance management measures – endorsed his case for implementing his reforms.

However, although he still wants trusts to take on more responsibility for care in their areas, he stepped back from the initial plan to give trusts responsibility for planning care.

He said: ‘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.’

A directorate would be established in the Department to performance manage trusts and improve lines of accountability, he added. It would ensure they meet targets and that trusts take responsibility if they underperform.

However, with elections to the Northern Ireland Assembly scheduled for May, it is unclear whether the plans will be carried forward.

In March, Mr Hamilton announced two further initiatives – a £30m transformation fund and an e-health and care strategy. He said the transformation fund would boost innovation, prevention and collaboration. The e-health strategy will use £1m from the fund to develop an electronic health and care record.