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Patients are the losers in Health Minister's plans

Victoria O'Hara's report (News, March 25) on the concerns of the chair of the Health and Social Care Board about Simon Hamilton's plans to abolish it, is timely.

Mr Hamilton is a minister long on rhetoric, but short on detail. In his November 2015 speech, he set out his response to the Donaldson report and the case for what he considered strategic reform of healthcare. Little in it was reforming, or new.

One of the proposals was the abolition of the Health and Social Care Board (HSCB). Mr Hamilton then launched a public consultation on the content of his November speech, again devoid of any detail.

It stands as possibly the worst public policy consultation document I have seen in 30 years working across the public sector.

We now know a little more of Mr Hamilton's interpretation of reform to remove bureaucracy. He proposes to take the functions of one body - the HSCB - and spread them across seven different health organisations, while redistributing the 600 or so HSCB staff across the system.

For most people working in the healthcare system, that is not a reduction in bureaucracy, but a full-on recipe for confusion.

Dr Ian Clements is right to raise the issues he does. Greater autonomy for Trusts may well lead to a postcode lottery in service-delivery, where patients and clients are the losers and with little confidence that the health department - well-removed from the service frontline - will have either the knowledge, or the capacity, to co-ordinate the huge reform of healthcare needed.

Many things in Northern Ireland are held up as innovative and reforming - tinkering at the margins of bureaucracy is certainly not one of them.


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