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Michelle O'Neill: The system is creaking - my reforms will create service fit for purpose

By Michelle O'Neill

Published 26/10/2016

Health Minister Michelle O'Neill has outlined her vision for the future of health care in Northern Ireland
Health Minister Michelle O'Neill has outlined her vision for the future of health care in Northern Ireland

I am proud of our health and social care service, the dedication and hard work of our staff and the quality of services available.

However, the system is at breaking point.

I have set out a very ambitious vision for our HSC. I am proposing a sustained incremental process of transformation and have set out priority actions for the next 12 months. I want to start work on transformation from today, working in partnership with those who use and deliver services. The report I've received, 'Systems, not Structures' by the expert panel led by Professor Bengoa, clearly sets out the need for change, which is now universally accepted.

By 2039 the population aged 85 and over will have increased by 157% compared to 2014.

Our HSC system needs to change to meet this growing demand and tackle the health inequalities that continue to persist in our society.

We have continued to increase investment in frontline services and in service developments and improvements. This has gone some way to stem the pressures the system faces.

However, it is not enough.

Our current delivery models are having an increasingly negative impact on the quality and experience of care. The reality is the current model is unsustainable for the 21st century.

We are ready for change - staff are crying out for it, political agreement has been reached and the public demand it. The time to act is now.

My vision, Health and Well-being 2026: Delivering Together, provides a roadmap for a radical transformation in the way we receive HSC services. It's ambitious and will require whole system, radical change to the way we access HSC services.

However, this is not a quick fix. Given the size and scale of the challenge I fully expect that the transformation process will take 10 years to implement and embed. But we must start planning now.

There has been a long-standing ambition to improve the health of our population - supporting people to keep well and make informed choices about their lives. Safe, high-quality care must be delivered in the most appropriate setting, ideally in people's homes and communities. I want to ensure we realise that ambition.

We will develop communities to become thriving and inclusive places to live. Primary care is the bedrock of our HSC system and we will support and enhance primary care teams so they have the capacity, tools and skills to treat and co-ordinate the majority of care for those they serve, helping people to stay well.

The role of our hospitals will fundamentally change to focus on addressing the needs of patients requiring complex planned surgery or emergency care in an inpatient setting. There is strong evidence that concentrating some specialist expertise, procedures and services in a smaller number of sites produces significantly better outcomes. Adopting this approach means not every service will be available in every hospital, but each and every one of us will benefit from safer higher quality outcomes.

Elective Care Centres will be developed to carry out less complex planned treatments. These centres will make better use of the resources we have through better organisation. This may mean you travel further for your treatment but there is strong evidence that such centres can reduce waiting times and provide a better experience for staff and patients.

I believe the approach we take to transformation is as important as the transformation itself. This vision can only be achieved through partnership working with those who use and deliver our services. We all have a stake in our HSC system - it belongs to us all. We will replace a culture of targets and blame with one that focuses on outcomes and improvements. Outcomes will be shaped by what matters to people, not just what's wrong with them; improvements will be led by frontline staff.

Then and only then, can we realise the full potential of our health service. I am confident that outcomes will be better, performance will improve, resources will be used more wisely and we can have an HSC service of which we can feel proud. We will be world-leading, ground-breaking and forward-thinking.

I am ready to take on the challenge, we all should be.

  • Michelle O'Neill is the Minister for Health

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