RPA THE STORY SO FAR

The RPA (RPA) was launched by the Northern Ireland Executive in June 2002 with the final outcome announced by the Secretary of State in November 2005. Its purpose was to review Northern Ireland’s system of public administration with a view to putting in place modern, accountable and effective arrangements for public service delivery in Northern Ireland. It allowed for joined up thinking and the promotion of key cross cutting values such as efficiency, equality, accountability and co-terminosity.

On 22 November 2005 the then Minister for Health, Social Services & Public Safety announced the reorganisation of Northern Ireland’s health and social services as part of the RPA. The result was to be significantly fewer health and social services organisations, including:

a reduction from 19 existing Health & Social Services (HSS) HSC Trusts to 6,
the abolition of HSS Boards and replacing them with the establishment of a single Health & Social Services Authority with seven LCGs to replace the current 15 Local Health and Social Care Groups, and
he establishment of one Patient and Client Council to replace the existing four Health and Social Services Councils.

A further announcement was made on 21 March 2006 about non-departmental public bodies and agencies, which abolished seven agencies and their functions, staff, assets and liabilities would be transferred to other HPSS bodies, including the proposed new Authority, HSC Trusts, and the Regulation and Quality Improvement Authority.

There were two major phases for implementation of the RPA within health and social care. The first phase involved the establishment of the 5 new integrated HSC Trusts and the retention of the NI Ambulance Trust with effect from 1 April 2007. The second phase was scheduled for completion by April 2008 and included establishing new organisational arrangements to replace the present four HSS Boards, four Health and Social Services Councils and a number of Agencies.

In taking up post as the new devolved Minister for Health, Social Services and Public Safety in May 2007, Michael McGimpsey advised that he wished to consider the Direct Rule proposals in more detail.

In consideration of these proposed reforms within the devolved administration context, it was decided to go back to first principles in order to have clarity about potential benefits as well as the essential attributes of any new structure. To that end, guiding principles and criteria were developed which were used to assess prospective organisational models including ensuring that any potential model would support democratisation within the system and enable enhanced involvement of local government in the delivery of health and social care.

Since 8 May the Minister has been involved in substantive engagement to determine the future structures for health and social care taking cognisance of the views of a wide range of people including patients, clients, carers and health and social care staff, to agree the scope of the review and communicate this with key stakeholders. The original RPA proposals were examined and a set of key guiding principles agreed as follows:

The service must be centred on the needs of patients, clients and carers.
Services must be efficient, with fair but challenging savings targets and all unnecessary waste and duplication eliminated. Value for money is crucial and therefore the delivery of services and all the supporting activities must be focussed on maximising benefits to patients, clients and carers.
Forward looking, innovative health and social care organisations will be encouraged delivering the services that they are commissioned to provide, adhering to priorities, meeting targets and ensuring that performance is always being improved.
Patients, clients and carers must be given the opportunity to voice their concerns and be sure that they are being listened to – dignity, respect, equality and fairness for patients, relatives and staff are at the core of the health and social care system.
Quality and standards will continually be driven up without compromise.

In addition, account has been taken of other models in England, Scotland and Wales, the Republic of Ireland (ROI), who have faced similar issues of reform.

On 9 October 2008 the Minister advised that although he was still giving thought to the changes being proposed under the Review of Public Administration, he confirmed that the current trust structures of five Health and Social Care Trusts and the Ambulance Service will remain largely as they were. He also advised that is was unlikely will be any further changes to structures before April 2009.

9 October press release

On 3 December the Minister provided an update to the Assembly on his current position with regard to reform of health and social care.

(3 December statement to the Assembly)

The Minister outlined his proposals for reform to the Assembly on 4 February and expanded on his proposals for public health reform on 18 February. The full proposals were also issued for full public consultation.

23 July 2008

The Health and Social Care (Reform) Bill has its First Reading in the Assembly

23 June 2008 - Press Release - Health and Social Care reforms move forward

1 July 2008

The Health and Social Care (Reform) Bill has its Second Reading in the Assembly. The proposals were approved in principle by the Assembly and will now move to Committee Stage. The Minister also outlined his proposals in more detail and this is contained in the announcement below.