Abbreviation HSC Parent organisation Department of Health | Region Northern Ireland | |
Type Publicly funded service Purpose Administration of the public health and other social care services Main organ Northern Ireland Executive | ||
Health and Social Care in Northern Ireland (HSC) is the designation of the publicly funded service which provides public health and other social care services in Northern Ireland. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom. For services such as A&E, patients simply walk in, state their name and date of birth, are given treatment and then leave. Patients are unaware of costs incurred by them using the service. It is sometimes called the "NHS", as in England, Scotland and Wales, but differs from the NHS in England and Wales in that it provides not only health care but social care too (the NHS in Scotland also includes social care). In England and Wales, the NHS services only provide health care. Social services are provided by local councils. The Health and Social Care service was created by the Parliament of Northern Ireland in 1948 after the Beveridge Report.
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Organisation
Hospitals in the province were managed by the Northern Ireland Hospitals Authority and Hospital Management Committees from 1948 to 1974, and then transferred to four health and social services boards, along with responsibility for social care. The pattern of local government in the Province was of 26 single-tier local authorities which, apart from Belfast, covered small populations ranging from 13,000 to 90,000 and were not considered an adequate base for the provision of personal social services.
The Health and Social Care (Reform) Act (Northern Ireland) 2009 led to a reorganisation of health and social care delivery in Northern Ireland, reducing the number of organisations involved. This Act established the Health and Social Care Board and five Health and Social Care Trusts which are responsible for the delivery of primary, secondary and community health care. The act also established five local commissioning groups which work in parallel with the health and social care trusts.
The Department of Health is now organised under a Permanent Secretary into several groups and one agency. These are the Planning and Resources Group, Strategic Planning and Modernisation Group and Primary, Secondary and Community Care Group and the 5 Professional Groups. The Department’s executive agency responsible for the oversight, coordination and overall provision of health and social care services is the Public Health Agency.
The five professional groups are
Trusts
Trusts are the statutory bodies responsible for the management of staff, health and social care services on the ground and have control their own budgets. The 19 Health and Social Services Trusts were merged into six Health and Social Care Trusts which became operational on 1 April 2007.
The 5 regional trusts are:
Ambulance Service
Northern Ireland also has its own dedicated Ambulance Service.
Primary Care
There are about 350 GP Practices in the province.
In 2016 Michelle O’Neill produced a plan to install a named district nurse, health visitor and social worker in every practice. 54 pharmacists are to start in practices in December 2016 with one in every practice by 2021. The number of GP training places is to increase to 111.
Prescription charges
On 29 September 2008 Health minister Michael McGimpsey announced that Prescription charges were to be phased out by April 2010, being first reduced to £3.00 in January 2009. This was widely accepted by the four main parties of the Northern Ireland Executive plus the Alliance Party of Northern Ireland. The move brought Northern Ireland in line with the Scottish and Welsh system's which had already abolished charges.
Performance
In Northern Ireland health and social care have been part of the same structure since 1974 but according to Terry Bamford "integration has failed to address a reliance on hospitals and institutional care which is significantly greater than elsewhere in the UK." He says that there are various reasons for this. It is difficult to get resources out of acute care without closing buildings, which is a political problem particularly in rural areas. Information technology systems may not be compatible and patient confidentiality hinders the sharing of information. Health services are free but social care is means tested. But, he says, "the greatest difficulties lie in the different cultures and values of health and social care."
Until 2014 the Kingsbridge private hospital in Belfast was used to reduce waiting lists for routine surgery. In September 2015 the Northern Ireland Health and Social Care Board admitted that waiting lists for surgery had grown and that they did not have the money to pay either NHS providers or the private sector to bring them down.
The NHS waiting list target in Northern Ireland is 52 weeks, not 18 as in England, and it isn't met. 10% of healthcare provided in the province is paid for privately.