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NHS Foundation Trusts: Review and Consolidated Accounts 2004–05

The Minister of State, Department of Health (Lord Warner): My right honourable friend the Secretary of State for Health has made the following Written Ministerial Statement.

In accordance with Paragraph 11(5) of Schedule 2 to the Health and Social Care (Community Health and Standards) Act 2003, Monitor's review and consolidated accounts of National Health Service foundation trusts 2004–05, HC 622, was laid before Parliament today. Monitor's statutory name is the Independent Regulator of NHS foundation trusts. Copies of the document are available in the Library.

Northern Ireland Review of Public Administration

The Minister of State, Northern Ireland Office (Lord Rooker): My right honourable friend the Secretary of State for Northern Ireland (Peter Hain) has made the following Ministerial Statement.

I am today announcing the outcome of the review of public administration in Northern Ireland. This review was launched by the Northern Ireland Executive in June 2002, but since the suspension of the Northern Ireland Assembly in October 2002 has been taken forward under direct rule. Discussions have been held with the Northern Ireland political parties at regular intervals as the review progressed, and Ministers also received advice from the high-level panel of independent experts that were appointed by the Northern Ireland Executive to work alongside the review team and provide an important independent element to the process.

The objective was to review the existing arrangements for the accountability, development, administration and delivery of public services in Northern Ireland, and to bring forward options for reform which are consistent with the arrangements and principles of the Belfast agreement, within an appropriate framework of political and financial accountability.

I am also conscious that the reduction in the number of local authorities will have a direct impact on policing structures, and on the arrangements for improving community safety through community safety partnerships. We will take forward changes in these areas in parallel with the work to implement the RPA, in partnership with the PSNI, Policing Board and other stakeholders who play an important part in the CSP arrangements.

The scope of the review was wide-ranging covering the 26 local councils, all the health and social service structures, all the education support structures, all
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other public bodies and the functions of the 11 central government departments.

The review has been conducted in an open and inclusive manner. It has been highly consultative, with considerable engagement with the full range of stakeholders from the outset, and two public consultations. The most recent consultation, which sought views on specific proposals for health and social services, education, local government and public bodies, ended on 30 September 2005 with more than 1,000 responses being received. The panel of independent experts worked very closely with the review team throughout the consultation process, participating in a significant number of the meetings with key stakeholder groups and ensuring that there was an agreed understanding about the key messages coming from the consultation.

There has also been an extensive programme of research including academic papers, study visits, surveys and focus groups. All of this evidence, including all of the responses to both consultations, has been published on the review website at and copies of the research papers have been placed in the House Libraries as they have been published during the course of the review. Today an integrated analysis of relevant equality, social need, good relations and rural issues has been published and placed in the Libraries of the House along with copies of the two consultation documents.

I and my ministerial team have been considering all of this considerable body of evidence, including the equality analysis, over the past few weeks before reaching final decisions.

In an ideal world Northern Ireland politicians in a local executive would be taking the decisions on the outcome of this review. However, it has been impressed upon me that the need for reform is urgent. We need to press ahead but do so in the expectation that there will be a return to devolution and that the new structures will work in that context. The changes I am announcing today will take a number of years to implement, and I would hope that there will be a return to devolution in Northern Ireland in the not too distant future that would allow local politicians to take ownership of and shape the implementation process.

The decisions I am announcing today have been taken in the context of four guiding principles that emerged from the consultation processes. These principles are:

These principles underpin a two-tier model within which all public services in Northern Ireland will operate. In future, the regional tier, which largely comprises central government departments, will concentrate mainly on policy development, strategic planning and setting and monitoring standards. At this level also those services that are essentially
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regional in character will be delivered either by departments or regional authorities. The sub-regional tier, that will have local government at its core, will be the main vehicle for delivery of local public services. This will result in the transfer of many service-delivery functions from central government to local government. However, whether local government delivers a service directly or not, it will have a greater influence over the planning and delivery of services within its boundaries through a community planning process which councils will lead.

Within this model there will also be formal arrangements to facilitate good co-operation between central and local government, the detail of which will be developed during implementation.

The key to making this model work is greatly enhancing the role and influence of local government. All of the evidence has pointed to the need to have a smaller number of much larger councils in order that those councils have both the critical mass and the capacity to take on a greater range of functions and exert influence on the full range of service-delivery bodies in their areas. I am therefore announcing that the current 26 local authorities in Northern Ireland will be reduced to seven, and that each council will have a maximum of 50 councillors. I intend to appoint a Local Government Boundaries Commissioner in the new year to draw up the boundaries of the new councils. I intend to bring forward legislation to direct the commissioner to use as a starting point the existing councils in the following groupings:
New Councils

New CouncilCurrent Councils
2Newtownabbey, Carrickfergus, Antrim and Lisburn
3Derry, Limavady, Magherafelt and Strabane
4Down, North Down, Ards and Castlereagh
5Fermanagh, Dungannon and South Tyrone, Cookstown and Omagh
6Ballymena, Ballymoney, Larne, Moyle and Coleraine
7Armagh, Banbridge, Craigavon and Newry & Mourne

In addition to community planning and a new power of well-being I propose that the new councils will have new or enhanced responsibility for:


Local roads

Conservation of natural and built heritage

Local economic development

Local tourism

Urban and rural regeneration

Rural development

Future European programmes

Environmental services

Application of building regulations
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Environmental health

Leisure and recreation

Arts and culture

Community development

Community relations

Emergency planning

Maintenance of the public realm.

Functions that are transferred to local government will be accompanied by an equivalent transfer of funding. To achieve this, a new system of local government financing will be developed.

A significant number of people expressed some concern about the way in which new councils will exercise their new powers. Taking account of these concerns and the calls for a robust system of checks and balances to ensure transparent decision-making, fair and equitable treatment for all and the protection of minority rights I am announcing that such a system will be included in legislation. However, this is a very complex and sensitive issue as we need to ensure that the system put in place achieves its objective without stifling innovation and the decision-making process within councils. Further work on the detail will be undertaken in the coming months, and I will want to consult further with the political parties that will be required to work the system.

I recognise that, with the reduction in the overall number of councillors resulting from these proposals, many councillors who have served their communities in Northern Ireland well through very difficult years may choose not to stand under the new arrangements. I have therefore decided that there will be a severance scheme to facilitate the reduction in the number of councillors. There will also be more appropriate remuneration for councillors in recognition of the responsibilities they will take on. Both these issues are being addressed by a Department of the Environment working group and I will take account of its report before deciding the details of the arrangements.

The consultation document also raised the issue of how to facilitate local involvement so that communities do not feel isolated from larger councils, and to ensure that the views of local communities are taken into account in council deliberations. It was suggested that this might be facilitated through an enhanced form of area committees (or "civic councils") in which the committees would have some form of civic role in their areas. I have decided that this should be a matter for the new councils, but will consider whether the legislation establishing the new councils should place a duty on the councils to develop a system to ensure that the views of communities are taken into account in council deliberations.

I am also announcing proposals for major changes to the health and social service structures in Northern Ireland. In place of the current four boards and 19 trusts, having taken account not only of the evidence from this review but also the recent report from Professor Appleby on performance management within the health and personal social services sector,
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I am proposing a single regional health authority to commission services, five trusts plus the ambulance service trust, the reduction of other support bodies from five to three, and the reduction of health and social services councils from four to one.

The regional health authority will not only replace the four boards, but will also take on several key functions currently undertaken by the Department of Health, Social Services and Public Safety. It will have seven local commissioning groups that will cover areas that are co-terminous with the new council areas to facilitate joint working, thus allowing councils to influence the planning of health and personal social services within their council areas to meet the needs of their constituents. My colleague Shaun Woodward, Minister for Health and Social Services in Northern Ireland, will make a separate Statement on the detail of the health and social services proposals.

On Education I am proposing a single education authority in place of the current five education and library boards. It will also take on education support functions currently delivered through a range of other education bodies including the Department of Education. The consultation document sought views on whether youth services and libraries should be transferred to local government. Having considered the views expressed on these issues during the consultation, I have decided that neither of these functions should transfer. My colleague Angela Smith, Minister for Education in Northern Ireland, will make a Statement on the detail of the proposals for education.

The decisions I have announced today in health and social services, education and local government will reduce the total number of public bodies in these sectors from 67 to 20.

The review also considered the future of executive agencies and other public bodies in Northern Ireland and a variety of views was expressed in the consultation. Work is under way to decide on the future of these bodies and I will make a further announcement on public bodies and their functions before the end of March 2006, when I have had time to consider all of the evidence and make considered decisions. As a result of this work I also expect to announce the transfer of significant extra functions to local government.

Separately and in the light of the current reform of the tribunal system in England and Wales, a working group with members drawn from the Northern Ireland Courts Service and those NI departments which sponsor tribunals has been established to examine the implications of these reforms for NI. As part of this work this group will review the current tribunal system in Northern Ireland in terms of efficiency, service delivery and independence, and also the judicial structures which support it, and consider the implications for the establishment of any new tribunals. The group is expected to report next year.

All of my decisions have been underpinned by detailed consideration of the implications for equality, social need, good relations and rural communities.
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There are clear expectations that my decisions will lead to improved accessibility to public services, particularly for those most vulnerable in our society, improvements in the diversity of people who participate in public life, and fair treatment for staff. I believe that these three issues should be a central part of the decisions taken within organisations, sectors and across the public sector as a whole during implementation.

I want to pay tribute to all those who work and have worked in the public sector in Northern Ireland and who have delivered public services through the past difficult years. I know I can count on them to continue to provide dedicated services to the public. I recognise that the changes I am announcing today will give rise to concern amongst staff about their future in the public sector. With this in mind, I propose to establish an independent advisory public sector commission to ensure the smooth transfer of staff to new organisations and to advise government on guiding principles which would apply to all sectors. Further work is being undertaken to finalise the details of the composition and remit of this commission.

Although the terms of reference of this review, drawn up by the former Northern Ireland Executive, precluded the number and configuration of the Northern Ireland departments, the decisions I have announced will have significant implications for departments. I will, therefore, be including departmental structures and responsibilities in my further discussions with all the political parties in Northern Ireland.

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