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Health and Social Care Board chief warned Simon Hamilton that closure was big risk

By Victoria O'Hara

The chairman of the doomed Health and Social Care Board (HSCB) warned Health Minister Simon Hamilton abolishing the body was a "backward step" in restructuring the health service.

In a letter sent to the DUP minister in February, Dr Ian Clements warned "there could be risks" in giving health trusts more autonomy, but added the HSCB recognised the need for reform to achieve a sustainable system.

Dr Clements, who practised as a GP for 27 years, wrote: "If trusts gain greater control without a co-ordinating body in place, there would be a risk of duplication in effort, inequity of service provision, reduction in efficiency and effectiveness, sub-optimal use of resources and more bureaucracy.

"It is important to stress that the challenges facing the HSCB, caused by constrained resources, an ageing population and a sub-optimal arrangement of services, will not be resolved by simply closing the HSCB.

"The real challenges facing the HSCB are not structural. Indeed, to remove the one body which can take an objective view of the issues at arm's-length from Government would be a backward step."

Despite the concerns raised, Mr Hamilton yesterday confirmed he would shut down the HSCB. 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. The move is part of a number of ambitious reforms Mr Hamilton pledged in a drive to improve the health service.

The HSCB, which commissions services for the trusts, employs about 470 people and has an administration budget of £27m. After a consultation on its closure began last year, the minister said there was "clear endorsement for the need to change". The consultation found there was a "broad agreement" its structures were too complex and too bureaucratic.

Last November Mr Hamilton proposed restructuring the health service following a report by Sir Liam Donaldson. "The most important people in this are the patients who will benefit from a streamlined system," he said. "These changes will help us achieve our goal of a world-class health and social care system."

Dr George O'Neill, a former Government adviser, said while the announcement was good news, the minister needed to act quickly. "You can't let the HSCB linger and die," he added. "There are lots of people in the board with organisational intelligence, which the department will need."

SDLP health spokesman Fearghal McKinney MLA said the decision would only mean "a change of name plaque on the door". "This decision, in the dying days of a mandate, amounts to a cover-up to disguise his failure to deal with issues identified five years ago," he claimed.

And Dr John O'Kelly, chair of the Royal College of General Practitioners NI, said the announcement lacked clarity.

"Primary care must be central if we are to reform the commissioning and planning process, so it is vital GPs and others working in the primary care sector are suitably involved in any decision-making at a local level, but what our involvement will be has so far not been clarified," he said.

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