Donaldson defends health report
The author of a £116,000 review of Northern Ireland's health and social care system has hit back at critics who branded his recommendations undemocratic.
Sir Liam Donaldson has called for an international panel of experts to overhaul the service and said political leaders should set aside parochial self-interest and pledge in advance to accept their advice.
He said: "It would be much better if there was all-party agreement. That is why I have suggested that they agree in principle to ask an international panel to make recommendations and then, unless there is very, very good reason - not just local self-interest - to agree to those proposals.
"I don't think it is undemocratic. It is analogous to binding arbitration."
In his report, published today, Sir Liam said the distribution of hospital-type facilities in Northern Ireland was "too wide" given the size of the population.
He also warned against retaining the status quo and said people should not fear change, including the closure of smaller hospitals.
Sir Liam added: "Up until now the door on change has been locked and padlocked and the padlocks have gone rusty. What I have done is I have taken those padlocks off, I have unlocked the door, I have thrown the door open and it is up to the people and politicians now to see if they want to walk through it and take those difficult decisions.
"But the decisions will lead to safer, higher quality care commensurate with the best in the world.
"If the public fully realise that by keeping things the way they are they are at heightened risk - most of the time their care is safe and secure but it isn't guaranteed - they are skating on very thin ice in lots of parts of Northern Ireland."
Sir Liam, a former chief medical officer in England who championed the smoking ban, was appointed to review how effectively the Department of Health (NI) and the health trusts have been performing.
It was ordered last April by the then health minister, Edwin Poots, after a major incident was declared at the Royal Victoria Hospital in Belfast when a backlog in A&E signalled a crisis in the system.
Although he identified long-standing and structural problems, Sir Liam acknowledged there had been no attempt to cover issues up and said the system was "no worse" in Northern Ireland than elsewhere in the UK.
However, the Transforming Your Care programme, aimed at increasing community-based care, required a "rocket-boost" to hurry its implementation, according to Sir Liam.
The review received a mixed reception from MLAs in the Assembly.
Health Minister Jim Wells said he took some comfort from the conclusions.
Mr Wells said: "The message from Sir Liam is clear, we now need a mature debate and we need to strive for political consensus to empower us to collectively make the right choice."
Sinn Fein's Maeve McLaughlin, who chairs the Stormont health committee, said: "There is little in this report that heralds the new dawn for our health and social care service.
"The report has cost £116,000 for eight months' work which has effectively told us that Transforming Your Care is too slow; that there are concerns in relation to commissioning which doesn't outline what those concerns are or how, indeed, they can be rectified; that the health and social care system is not the one we need; and that there will be a statutory duty of candour, a direction for pharmacy and there is a need to strengthen serious adverse incidents."
Alliance Party MLA Kieran McCarthy, who is also a GP, said Assembly members had "reports and reviews coming out of our ears" while Michael McGimpsey, a former Ulster Unionist health minister, said there was not enough money to run the health service.
"You either increase the money or you reduce the service," said Mr McGimpsey.
The most scathing criticism came from North Antrim MLA Jim Allister, who described some of the recommendations as undemocratic.
The TUV leader said: " Surely that has to be the most totalitarian, undemocratic recommendation ever seen.
"It suggests that all the political parties and the public in Northern Ireland should abdicate their critical faculties, sign up to accept whatever is proposed by some faceless panel about the future configuration of our hospitals, and merely deliver whatever it is they say. Has there ever been a more totalitarian suggestion?"