Health and Social Care Board to be closed down
Northern Ireland's Health and Social Care Board (HSCB) is to be closed down, the health minister said.
The board commissions services for the six health trusts that deliver the NHS.
Simon Hamilton said the system did not work and inhibited innovation.
He said: "What I am signalling is an end to the current way we commission healthcare in Northern Ireland. It has not worked and arguably is never going to work well in a small region like ours."
It is part of a parcel of the most wide-ranging reforms in Northern Ireland for five years.
Other key changes include:
:: A panel of experts is to be established to redesign health and social care facilities.
:: A Transformation Fund is to be created to pay for cost-saving initiatives.
:: The Public Health Agency (PHA) will work more closely with the Department of Health on early intervention and prevention measures.
:: The health trusts which deliver services are to become more accountable.
Some trade unionists said the measures would leave staff worrying for their futures. Others said commissioning was wasting up to 15% of the health budget each year.
Mr Hamilton declared: "I want to see the department take firmer, strategic control of our health and social care system, with our trusts responsible for the planning of care in their areas and the operational independence to deliver it."
He added: "I propose that we close down the Health and Social Care Board. This is about structures, not people.
"The board has many talented people working within it, doing many important things to a very high standard.
"But the administrative structures created during the last Assembly term do not serve us well, especially as they blur the lines of accountability and weaken authority."
The board employs about 470 people with an administration budget of £27 million.
Mr Hamilton said: "My proposals would mean that many of the board's existing functions, and staff, would revert back to the department. Some would move to the new Public Health Agency. Whilst others, especially those in respect of planning for need, will move to our trusts.
"My vision is for greater operational freedom and flexibility for trusts. This is essential if they are to build on the huge innovative potential of staff across the sector.
"But with greater flexibility comes the need for sharper, and more rapid, accountability."
The change follows a review by the former chief medical officer for England, Sir Liam Donaldson, that urged the department to simplify the existing system and make it more efficient.
The health service is facing the challenge of an ageing population with more chronic conditions like diabetes.
Stormont as a whole has been gripped by budget uncertainty because of the dispute over welfare reform.
Mr Hamilton's other proposals include:
:: Making the health trusts which deliver services more accountable.
:: Organising a health summit involving all parties to develop a shared vision for a transformed health and social care system.
:: Seeking increased health spending in the next budget.
Board chief executive Valerie Watts said there were always opportunities to change and improve and the organisation had been simplifying decision making, reducing bureaucracy, increasing the focus on longer term planning and strengthening accountability.
"We are fully committed to minimising any impact on staff and ensuring that we fully utilise their skills, expertise and commitment moving forward.
"The important work carried out by the HSCB in planning health and social care services will continue, as will our absolute focus on ensuring people in Northern Ireland have access to safe, quality and sustainable services now and into the future."