GPs seek contract guarantee as Northern Ireland plans national health board abolition

GP leaders have called for assurances that their independent contractor status will be maintained after the Northern Ireland government announced plans to abolish the Health and Social Care Board (HSCB).

Dr Tom Black: Independent contractor status must be guaranteed
Dr Tom Black: Independent contractor status must be guaranteed

Health minister Simon Hamilton announced a radical reorganisation of healthcare including taking government control of strategy and handing operational powers to trusts.

The minister, responding to a report published in January by former chief medical officer for England Sir Liam Donaldson, said there was too much bureaucracy and too many layers in the system.

Under the proposals the board - which is the commissioning and strategy body for Northern Ireland's health and social care service - would be closed down. Northern Ireland's five regional health and social care trusts would take control of planning for need and be given greater operational freedom and flexibility.

GP bureaucracy

The GPC welcomed the move to reduce bureaucracy, but sought reassurances over GPs’ contractual status under the proposed regime.

Under the plan, trusts would work more closely with local GPs, said Mr Hamilton. ‘I believe that together they know best what the people in their areas require in terms of health and social care provision.’

He added: ‘I am encouraged by the ongoing development of GP federations and the potential they offer.’

Some of the board's functions will be handed to the Public Health Agency, while a panel of experts will be assembled to lead a debate on the best configuration of the health and social care service.

The plans will be opened to consultation and a summit of all the parties in Northern Ireland will be convened by the minister to agree a vision for the future of the service.

Mr Hamilton said: ‘From conversations I have had with clinicians it is clear that many feel that our commissioning system doesn’t work, they don’t understand it and, worst of all, it actually inhibits innovation. Our commissioning system isn’t as effective as we need it to be. Whether this is because of shortcomings in the model or in its implementation is immaterial.

Healthcare commissioning

‘We have too many layers in our system. I want to see the [health and social care] department take firmer, strategic control of our health and social care system with our trusts responsible for the planning of care in their areas and the operational independence to deliver it.’

GPC Northern Ireland chairman Dr Tom Black welcomed the government’s moves to reduce bureaucracy.

‘The BMA was pleased to see the recognition of the work already done by GP federations in Northern Ireland, and would be keen to see the funding needed for them to be fully operational to be released as soon as possible,' he said.

‘In relation to the organisation of services, we have always said what Northern Ireland needs is the right services in the right place at the right time for patients, and the minister seems to be in agreement.

‘The GPC has asked for an early meeting with the minister to ensure that the position of GPs as independent contractors is maintained within these changes as general practice is the foundation for much of the health service.’

Photo: Pete Hill

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