The Northern Ireland Assembly Executive launched the Review of Public Administration (RPA) 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.
Within health and social care, there have been two major phases for implementation of the RPA. The first 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 was originally 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 October 2007, following the re-establishment of the devolved Assembly, Health Minister, Michael McGimpsey advised that he wanted to give more thought to the changes proposed under the Review of Public Administration. In considering the 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.
The Minister engaged in a wide ranging consultation process about the future structures for health and social care, taking on board the views of patients, clients, carers, communities and other stakeholders. The consultation centred on proposals published by Minister McGimpsey in February 2008. The key elements of the proposals were as follows:-
- a regional Health and Social Care Board (HSCB), to replace the four Health and Social Services Boards, which will focus on commissioning, resource management and performance management and improvement;
- a regional Public Health Agency (PHA) that will incorporate and build on the work of the Health Promotion Agency but will have much wider responsibility for health protection, health improvement and development to address existing health inequalities and public health issues for all the people of Northern Ireland;
- a regional Business Services Organisation (BSO) to provide a range of support functions for the whole of health and social care system; and
- a Patient and Client Council (PCC) to replace the Health and Social Services Councils to provide a strong voice for patients, clients and carers.
For further information on the reform process see the timeline of events.
The five Health and Social Care Trusts are structured as follows:-