Appoint health 'supremo' to shake up heathcare reform, Sir Liam Donaldson says
A health "supremo" should be appointed for one year to kickstart a stalled healthcare programme in Northern Ireland, the former chief medical officer of England has said.
Sir Liam Donaldson said if he was in charge of the Northern Ireland health service, he would appoint "somebody good" to finally get Transforming Your Care - the plans to radically change the healthcare system - "gripped and moved forward".
He made the comments while giving evidence for more than two hours to Stormont's health committee yesterday.
It came a day after Sir Liam, who was tasked with carrying out a review into the Northern Ireland health service, published his report, which includes 10 recommendations. He carried out the review of the health service following widespread concern over standards of care.
Published in 2011, Transforming Your Care was supposed to divert people away from hospitals and improve community-based services - but it has yet to be properly implemented, heaping pressure on hospital staff and prompting accusations the health service is in disarray. One of Sir Liam's recommendations was that "action not words" were needed over TYC.
He was questioned by DUP MLA Paul Givan about how, given the financial pressures facing the health budget, TYC could be moved forward.
"If I was in charge of that, I would put in a supremo for at least a year to really get this going," he said. "I'd put one person accountable to the Permanent Secretary in overall charge and say: 'Right, get this going'.
"I think it needs to be gripped and moved forward in a very authoritative way. Personally, my management solution to that would be put somebody good in overall charge."
He appeared alongside Permanent Secretary Richard Pengelly, chief medical officer Michael McBride and chief nursing officer Charlotte McArdle.
Chair of the health committee Maeve McLaughlin also quizzed him over his recommendation for both politicians and the public to sign up to the decisions of a panel of international experts before they begin their work to overhaul the entire health system.
"I would take issue with the fact that what is recommended is accepted in advance and I think that is a step too far, way too far," she said.
In the report, Sir Liam also said that medical facilities needed to be "right for the size and needs of the population".
Sir Liam said he would "not be drawn" on the closure of hospitals after being pressed by Alliance's Kieran McCarthy on the issue.
He refused to define what is a hospital because there is such a wide range of facilities.
"But I will say that the range of health facilities in Northern Ireland, including hospitals, would be better for change that it is at the moment," he said.
Sir Liam's comments on TYC come as Derry GP Dr Tom Black, the British Medical Association Northern Ireland General Practitioners Committee chair, voiced fresh concerns over the lack of progress implementing the policy.
"TYC is still seen by minister (Jim) Wells and our senior civil servants as the way forward, despite the fact that there is clearly no funding available to see its implementation. On top of this, we noted that Sir Liam Donaldson's report recommended that a new costed, timetabled, implementation plan for TYC should be produced quickly."
"Something I would say is that in the modern world of healthcare, health facilities take all sorts of different forms, and there is no question what would be replacing anything that was changed in your system would be an advance and improvement on what had gone on before."