A raft of proposals aimed at saving the health service – including cutting 180 hospital beds and halving the number of statutory residential homes – has been given the green light.
However, Health Minister Edwin Poots has ducked out on making a decision on the future of the Causeway Hospital in Coleraine – opting instead for further consideration on the matter.
He has given officials six months to produce options.
These will then be subject to public consultation, so it will be next year at the earliest before any changes are made to the management of the Coleraine hospital, run by the struggling Northern Health and Social Care Trust.
The Department of Health team will look at the possibilty of transferring the hospital to the Western Trust and any implications for services as a result, including the future of the emergency unit.
He has also to decide on the location of one of two planned inpatient acute mental health facilities in the Western Trust. The proposals rubber-stamped by Mr Poots include:
• Closing half of statutory residential homes to a figure of 27 over the next three to five years.
• Cutting 180 hospital beds.
• Provision of an additional 479 supported living places for older people.
• £1m investment to train nursing home staff to support people at end of life.
• Development of six inpatient acute mental health units for adults, with one sited in the Northern, Southern, South Eastern and Belfast areas and two in the Western area.
• £8m investment in cardiac catheterisation service.
• £7m will be invested in additional orthopaedics capacity in the Southern, Western and Belfast Trusts by March 2015.
Mr Poots acknowledged some of the plans may cause concern but said they are necessary and ultimately will improve patient care.
Addressing concerns over the reduction of residential homes, he stressed that the public will not be expected to pay top-up fees when a person is placed in a privately-run residential home.
"I want to assure you that where a trust is unable to secure a statutory residential place at the core rate of £550 and uses a higher rate place within the independent sector, then the trust will pay the difference in costs," he said.
While Mr Poots has said his Transforming Your Care reforms will improve the NHS, public service union Unison branded the review as "plans to cut, close, downgrade and privatise".
Patricia McKeown, Unison's regional secretary, said: "The closure of 180 beds in a health system which is already reeling from too many bed closures is designed to reduce nurses and other healthcare staff. It will throw A&E departments into deeper crisis."
Questions and answers
Q What is Transforming Your Care?
A Transforming Your Care is the biggest review of health and social services in Northern Ireland in a generation.
It was commissioned by Health Minister Edwin Poots when he took over the Department of Health.
The review team, led by John Compton — chief executive of the Health and Social Care Board — produced a document containing 99 proposals. The health trusts were asked to develop their own plans for the future of health delivery based on the 99 proposals.
Q Is Transforming Your Care necessary?
A The health service is struggling to cope, yet demand for services is predicted to grow by around 4% a year until 2015.
With a growing and ageing population, the need for reform has been recognised for some time.
Q Will Transforming Your Care deliver?
A This remains to be seen. While there is broad support for the direction there are concerns over funding the changes.
Ultimately it will mean health trusts handing over millions of pounds to the primary sector.