Healthcare news

ANALYSIS: Timing of 'bold and brave' move is interesting

Health minister Simon Hamilton
Seanín Graham

SIMON Hamilton’s damning assessment of a top-heavy, bureaucratic NHS mirrors that of former NIO minister Shaun Woodward almost a decade ago.

Wednesday's announcement that a central tier of this bureaucracy is to be axed was, for some observers, something that should have happened several years ago as part of a wider shake-up of the public sector.

The timing of Mr Hamilton's "bold and brave" move - as he described it in his speech - is an interesting one, coming so soon after his credibility was seriously damaged as an 'in-out' minister during a period of extreme waiting list pressures.

The DUP minister and party colleagues were also criticised after the Irish News revealed they were being paid for their short periods in office despite claims they would not be receiving any money.

While the shelving of the Health and Social Care Board - an organisation that employs 600 staff and was paying out almost £30m on salaries in March this year - is significant, the reality is that many of those employees will be redeployed elsewhere.

Many administrators will in fact remain in the same Belfast city centre building in Linenhall Street because there simply isn't enough room for them at the Department of Health offices in Castle Buildings or in some health trust facilities.

What would have been more brave was if Mr Hamilton took charge on key issues relating to downgrading of hospitals - especially with an election looming.

The case for slashing the north's 10 acute A&E hospitals in half due to our small population has been well-documented for more than a decade - and reinforced by a scathing report earlier this year by a former English chief medical officer.

Sir Liam Donaldson's no-holds barred review also called for an overhaul of the Health and Social Care Board, stating that commissioning wasn’t working, and raised serious concerns about who was actually in charge of the health service.

Mr Hamilton insisted on Wednesday he was very much at the helm – and that he does not want the "buck-passing" culture to continue.

However, under the new systems he has outlined, the buck will directly pass to health trusts and their chief executives as to what budgets will be available for services - and in turn what acute hospitals can continue to operate.

Interestingly, the actual review which governed Mr Hamilton's decision to abolish the Board was not published yesterday.

Normally, an important document like this would be released followed by a ministerial statement and then a period of public consultation to decide the way forward.

Instead, Mr Hamilton’s statement will be followed by a consultation - even though a decision has already been made. The move has understandably upset the top brass at the Board and called into question the process used.

It can only be hoped that the intent behind the DUP minister's sudden announcement is an earnest one - and not an attempt to salvage a political reputation ahead of an election.

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