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We deserve a world-class NHS, and that means reform


Almost 70,000 people work in Northern Ireland’s healthcare system

Almost 70,000 people work in Northern Ireland’s healthcare system

Belfast City Hospital

Belfast City Hospital

Royal Victoria Hospital

Royal Victoria Hospital

Almost 70,000 people work in Northern Ireland’s healthcare system

Northern Ireland's health and social care service is not perfect, but as Simon Hamilton embarks on the biggest shake-up in its history he says his aim is to create exceptional outcomes for all patients.

Given the scale of the challenges facing the health service in Northern Ireland it is perhaps easy to criticise performance in the system but, in so doing, forget the exceptional work that is conducted across our health service each and every day of the week.

As a fairly frequent user of the health service, I see first-hand the excellent staff, cutting-edge technology and also the problems from time to time.

Last week this newspaper described Northern Ireland's health service as "critically ill". That is quite an accusation and would be deeply worrying if it were true.

On the day those words appeared in print in this paper, our near-70,000 staff across the health and social care system were investing around £10m in providing care to thousands of people across our province who need it, including:

• Nearly 6,000 outpatient appointments.

• 1,700 inpatient or day case hospital admissions.

• 2,000 emergency department attendances.

• Domiciliary care packages for around 24,000 people.

• 44,000 GP consultations.

• Almost 5,000 courses of dental treatment.

• Care for 5,000 patients in hospital beds.

• The dispensing of 120,000 prescriptions.

That doesn't strike me as the sort of output that comes from a health and social care system that is on its last legs, as some might suggest. It sounds more to me like the output of a system that is working hard for the people of Northern Ireland in very challenging circumstances.

I will be the first to hold my hands up and admit that our health and social care system isn't perfect. Find me one anywhere in the world that is.

You don't have to try too hard to see the problems of the health services in the rest of the UK, or indeed in Ireland.

But I am not content to seek solace in the woes of other Health Ministers. And nor am I prepared to sit back and do nothing while the health service in Northern Ireland faces arguably the greatest challenge in its existence.

While I am proud of what our health service is doing for people in Northern Ireland, I am all too aware that if we do not get to grips with the challenges that flow from a growing and ageing population, a rise in chronic conditions and unhealthy lifestyles, then the health service we cherish will genuinely be in danger.

That's why I have embarked on the biggest shake-up in our health and social care system for a generation. The appointment of an expert panel led by Professor Rafael Bengoa to lead the debate on how we can deliver a world-class health and social care system in Northern Ireland is another important step forward in the implementation of the radical and far-reaching reform plans I outlined last November.

We recently commenced a consultation on my proposal to remove an entire layer of bureaucracy from the health and social care system by closing the Board, and I am committed to using some of the increase in expenditure my department was granted in the 2016/17 budget to create a transformation fund to help make the service delivery changes we need a reality. Much-needed reform is well under way.

We do not have the luxury of being able to sit back and do nothing. Reform is not some optional extra. It is a necessity. If we want to conserve what is best about our health service, we must change.

The very future of the health service we love should be incentive enough to reform and change how we do things. But I want us to use the opportunity that change presents to not just ensure that our health service survives, but also engender a transformation that makes it thrive.

I want to create a health and social care system the people of Northern Ireland can be proud of, but I am also ambitious for us to have a health service that is viewed as an exemplar internationally. We already have many areas of our health service which we can point to and say without fear of contradiction that they are genuinely world-class, and many of my reforms are about spreading that excellence across all parts of our system.

For me, a truly world-class health service is one that puts the patient at the centre. We must never lose sight of the fact that reform is first and foremost about constructing a system that can better serve the people of Northern Ireland who use it.

This is not about the system itself, or anyone in the system, and certainly not about any vested interest within the system. This is exclusively about improving outcomes for patients.

Importantly, there is now a growing acknowledgement of the need to change. Not just change for change's sake. But change that enhances the experience of patients.

This week, the Northern Ireland Confederation - an organisation made up of 50 organisations, including many from within the health and social care system - said that we need immediate action "if we are to provide the citizens of Northern Ireland with world-class health and social care outcomes now and in the future".

So, it is clear that the system itself acknowledges the need for reform and is, in fact, actively encouraging all of us at Stormont to press ahead with ambitious change.

In my opinion, what has inhibited the realisation of much-needed reform in the recent past hasn't been a lack of ambition from my party, or indeed support from inside the system. It has been a lack of willingness on the part of some politicians to accept that change is needed and to support even elementary reforms.

Many who have criticised the pace of change are the first to rush to protest at the most minor and common-sense of reforms. But there are some signs of hope.

Stormont's Public Accounts Committee (PAC) has this week called for a transformation of how health and social care services are delivered. This is a helpful and timely contribution to the debate. Given the cross-party nature of the PAC, I hope this indicates an appetite for the very reforms I have already set in motion.

In the next number of weeks the expert panel will convene a political summit where we will seek to establish a consensus about the future of health and social care here.

Our political system means that agreement between parties is required if we are to reform our health service in a way that improves outcomes for patients.

I hope that others engage with the summit in a positive and constructive way, listening to the calls from inside the system for change and focusing on the need to deliver a world-class health service for all of our people.

Reform and change are not threats to our health service. What is a threat is a failure to recognise the gravity of the challenges we face and a failure to respond to them.

I want our health service to be able to conquer those challenges and remain true to its founding principles in the process.

This is not a time to be overawed by the immensity of the challenges before us.

It is a time to tackle them head on, putting the patient at the heart of all that we do and not seeking to sustain a system that will surely fail without reform.

Simon Hamilton MLA is Minister of Health

Belfast Telegraph