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Northern Ireland Review of Public Administration: Future Health and Social Care Structures

Lord Rooker: My honourable friend the Parliamentary Under-Secretary of State for Northern Ireland (Shaun Woodward) has made the following Statement.

I am today announcing my plans for future health and social care structures in Northern Ireland. The Secretary of State for Northern Ireland's announcement on the review of public administration in Northern Ireland sets out the background to the review; reflects on the consultation process and sets out the key changes for public administration in Northern Ireland.

The current organisation of health and social services in Northern Ireland is too cumbersome, too bureaucratic and hugely inefficient. It produces inequalities and unacceptable delays for treatment.

I have already begun a rapid programme of reform and modernisation. By March 2006 people will wait no more than 12 months for in-patient and day case operations and from March 2006 the targets for replacement hips and knees will be no more than nine months, for cardiac surgery no more than six months and for cataracts no more than six months. I am also driving a £2.2 billion investment programme across
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the health and social services with developments at all major hospital sites and across the primary and community sector.

The next step is to put in place structures which are patient-led, patient-centred and patient responsive and which will free resources for investment in front-line health and social services.

I will replace the four health and social services boards and create a new statutory strategic health and social services authority which will be responsible for performance managing the health and social services, ensuring that services are accessible, responsive, high quality and efficient.

Some of the functions currently exercised by the Department of Health, Social Services and Public Safety will transfer to the new authority. The department's primary function will be to set policy and targets and it will be a significantly smaller, more tightly focused body.

Seven primary care-led local commissioning groups will be established, patterned on the proposed areas of the seven new district councils. Acting as local offices of the strategic health and social services authority, the local commissioning groups will work in conjunction with local primary care practitioners and the authority to commission services from trusts. These commissioning arrangements will be developed in consultation with primary care professionals and could evolve to primary care-led commissioning arrangements along the lines of proposals currently under development in England.

Five new integrated health and social services trusts will replace 18 of the 19 existing trusts bringing the total number of trusts to six, including the Northern Ireland Ambulance Service, which will continue to provide a regional ambulance service. As a result of having a greater critical mass these trusts will create and develop new linkages between hospital and community-based services.

I will replace the four health and social care councils with a powerful single patient and client council which will engage with people and communities to promote health and well-being, ensure that services are responsive and patient-centred and that decisions reflect public priorities.

I also intend to incorporate the Health Promotion Agency into the new strategic health and social services authority and the Regional Medical Physics Agency into one of the new trusts, thus reducing the number of regional service delivery bodies to three. The remaining regional service delivery bodies will be the Central Services Agency, the Guardian Ad Litem Agency and the Blood Transfusion Agency.

I am content for now that there is a case for retaining in their present form the remaining smaller NDPBs which did not fall within the remit of the review of public administration but I expect them to work closely with other health and social services organisations to reduce their management costs.
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I will sympathetically consider the case for locating the new strategic health and social services authority and the new patient and client council outside the Belfast area.

These new structures will be put in place as quickly as possible. With immediate effect, groups will be identified to lead the development of the new trusts which will require subordinate legislation and which will become fully operational by 1 April 2007. Over the coming months we will develop our model of a strategic health and social services authority, which will require primary legislation, and the new primary care commissioning arrangements. This will be done in consultation with health officials, doctors, pharmacists, social workers, dentists, nurses and other health and social services professionals with a view to having these formally in place by 1 April 2008.

We will also explore ways in which we can devolve commissioning power to local primary care-led groups in advance of the strategic health and social services authority and the local commissioning groups being established. The speed of this reorganisation will understandably give rise to concerns among people working in health and social care services and indeed in my department. I am, however, committed to ensuring that every reasonable effort is made to avoid compulsory redundancies while at the same time taking into account the legal rights of staff in the context of fundamental change to terms and conditions of employment and work location.

I am, however, satisfied that implementation of these proposals will ensure that the health and social services in Northern Ireland become genuinely patient centred and more accessible. They will also be more effective and efficient with a greater proportion of expenditure devoted to front-line service delivery and development.

Northern Ireland Review of Public Administration: Implications for the Education Sector

Lord Rooker: My honourable friend the Parliamentary Under-Secretary of State for Northern Ireland (Angela Smith) has made the following Ministerial Statement.

The Government in Northern Ireland are today publishing their decisions on the review of public administration (RPA) consultation. My right honourable friend the Secretary of State for Northern Ireland (Peter Hain) has already made a Written Statement today in the House setting out the broad range of change across the entire Northern Ireland public sector. This Statement sets out decisions relating specifically to education and how the change process will be managed.

I want to thank those who have responded to the consultation process, and to acknowledge the significant contribution which these responses have made to the consideration of the RPA proposals. Some 687 responses, two-thirds of the total responses
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received, were related to the education proposals and as such demonstrated the interest, energy and commitment of respondents to the change process.

The analysis of the responses revealed that there was broad support for radical reform, for refocusing the role of DE, for the establishment of a single education body, for reviewing advice services, for enhanced local involvement and for the better provision of services at the front line.

Concerns were also raised, including the perceived absence of a clear vision for education, the implications of creating two education bodies, the threat to the ethos and autonomy of individual schools, the impact of change at local level and the possible dangers of a strong centralised administration system.

All the responses received have been considered carefully against the Government's plans for a modern, accountable and responsive framework within which education policy can be developed, implemented and monitored more effectively, in the interests of improved services for all.

The changes I am announcing today are substantial and will impact upon staff in all parts of the education service. Despite the unavoidable upheaval, I know that through the period of change we can continue to rely on their professionalism and commitment in shaping the future in the interests of young people and their families.

Against this backcloth I have made the following decisions.

Changing the Department of Education The Department of Education will undergo significant change to enable it to focus more effectively on strategy, policy development and on the translation of policy into improved outcomes at the front line. The department will set the overall strategic direction of the education and youth sector. Its future relationships with others will be focused on clear accountability and improving standards, with performance and quality indicators established from the outset, giving strategic direction to the delivery of services. Funding allocations will be linked closely to policy priorities and performance improvement. In future, there will be a clear separation between policy formulation and operational delivery, resulting in the transfer of certain functions from the department to the proposed new education authority.

This refocusing of the department's role will require significant internal change, with closer alignment of the strategic planning, policy-making, accountability and resource allocation functions and a stronger focus on the information and evidence base needed to inform policy decisions.

These changes to DE will present challenges for the department and its staff. I recognise the concerns of staff and trades unions about the transfer of functions and jobs out of the NICS to a new education authority. I am satisfied, however, that the weight of the argument is in favour of transferring a number of operational activities from DE. I have asked DE to
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carry out an immediate internal review to confirm those functions which will transfer and to put in place appropriate transition arrangements, in co-operation with staff and their relevant unions.

In reshaping the role of DE I am mindful that education, alone, will not be able to deliver the improvements needed and I will be putting in place effective arrangements to enable DE to work collaboratively and constructively with other departments, agencies and institutions in the interests of children and young people.

Changing Education Support Having considered carefully the diverse views expressed about the nature and purpose of the support arrangements I have decided that there will be a single education authority (EA) and not two bodies, as suggested in the consultation document. The Education Authority will have responsibility for the functions performed currently by the education and library boards, the Council for the Curriculum Examinations and Assessment (CCEA) and the Regional Training Unit (RTU). It will also have responsibility for the front-line support and related functions currently undertaken by the Council for Catholic Maintained Schools (CCMS), the Northern Ireland Council for Integrated Education (NICIE) and Comhairle na Gaelscolaiochta (CnaG). The Education Authority will become the employing authority for all teaching and other staff employed in grant-aided schools. With regard to the Staff Commission, the creation of the Education Authority will mean that some of its function will be absorbed into the authority while others will no longer be required.

The responses to the consultation reflected a concern that the proposals had the potential to undermine the ethos and status of schools. I appreciate fully the strength of feeling on this matter. I want to assure everyone involved that the new arrangements do not weaken or undermine the role of governors. Nor do they alter the ethos of individual organisations or schools. For me, ethos is developed within the organisation and is influenced by the values of governors, staff, parents, pupils and the local community.

Under the new arrangements boards of governors will largely retain the role they currently play in relation to the selection, appraisal, promotion and dismissal of teachers and other school-based staff. They will continue to make the key decisions regarding the appointment and management of staff. The role of the Education Authority will be to ensure that decisions are taken within a framework which is consistent across all schools, is driven by the need to raise standards; and which reflects best practice in people management within the terms of existing employment legislation.

The ownership of the controlled schools estate, currently with the education and library boards, will transfer to the Education Authority. This decision will not confer advantages to schools in the controlled sector nor disadvantage any other grant-aided school.
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The legislation which I will be bringing forward will explicitly ensure that the Education Authority will provide funding, services, advice and support to all grant-aided organisations on an equitable basis, irrespective of ethos or ownership considerations. The Education Authority's relationships will be consistent and support governors and staff in their work. The department will ensure that all necessary controls are in place to deal with potential conflicts of interest and to ensure fair and equitable treatment for all.

In reshaping the delivery of support, I am determined to ensure that the Education Authority achieves no less than the very highest standards of service provision. In monitoring and evaluating the performance of the authority, its services will be benchmarked against best practice.

The Education Authority will be fully and directly accountable to the Department of Education, in particular for the delivery of effective and efficient services. The authority will be governed by a board, appointed in accordance with the principles set out by the Office of the Commissioner for Public Appointments.

I am conscious of the need to ensure that the Education Authority is given sufficient flexibility to determine its own internal structures and working arrangements. However, there are three areas in particular which should be built into the organisational framework from the outset. These are:

I am mindful of the uncertainty and genuine concerns of staff employed in the education and library boards and the other bodies affected by these changes. It will be important that staff concerns are identified and addressed at the outset, and of course education staff are not alone in this regard. With this in mind my ministerial colleagues and I have agreed to establish a public service commission to advise on the principles and steps necessary to ensure the smooth transfer of staff to new organisations in a fair and consistent manner.

Changing Inspection, Monitoring, Research and Advice The inspection and monitoring of all education and training establishments and services will be the direct responsibility of the Education and Training Inspectorate, which will be operationally independent of all service providers and users. The inspectorate will evaluate the impact of these services for the key purposes of promoting improvement in learning and
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teaching and of informing policy discussions and decisions. Evidence from inspection will be used to assure government and the public on the quality and standards of services.

The Education and Training Inspectorate will continue to provide inspection services for DE, the Department for Employment and Learning (DEL) and the Department of Culture, Arts and Leisure (DCAL). The chief inspector or nominee will be an integral member of departmental boards at which all strategic departmental and policy issues are discussed. On all education policy initiatives, the inspectorate will provide an independent professional assessment of the effectiveness of the existing or proposed new policy. The inspectorate will plan and implement its programme of work operating through a service level agreement agreed with each Permanent Secretary. The Minister or a Permanent Secretary may, from time to time, invite the inspectorate to carry out special assignments, as appropriate. The Minister will meet the chief inspector to receive regular reports across the range of professional educational issues.

A new statutory Education Advisory Forum will be established to act as a unified advisory interface between the department and the education sector. Its membership will include representatives from the transferors and trustees, as well as the integrated and Irish-medium sectors and voluntary grammar schools. Members of the advisory forum will provide ongoing advice to the department. The forum will also meet the Minister for Education on a regular basis.

The establishment of the Education Advisory Forum will provide new, more effective mechanisms through which the department can commission and receive advice. The statutory advisory role of CCEA and CCMS will be repealed and there will also be fundamental changes to the relationship between the department and other organisations providing advice. Consequently, DE will review existing arrangements to streamline and improve co-ordination. This will improve decision-making and strengthen the local advisory role, as set out in the consultation report. The review will help to inform the constitution, roles and responsibilities of the advisory forum. It will give specific consideration to the most effective ways of providing a voice for parents and young people in influencing decision-making on education.

The review will consider the department's wider engagement of education stakeholders within a social partnership model, with the aim of strengthening the channels of communication with the teachers' unions and other interests. This review will lead to more direct engagement with boards of governors, school principals and teachers to ensure that their views are considered.

Changing Youth Services DE will continue to be responsible for youth service policy and strategy, but will link this increasingly to wider education priorities. In strengthening the relationship between youth provision and formal education, youth services administration will be placed within the Education Authority, as will the
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functions of the Youth Council. A Northern Ireland Network for Youth will be established to strengthen the direct voice of young people in all relevant aspects of government provision. The role of district councils in youth service provision will be strengthened also through new district youth networks.

Changing Procurement Earlier this year, the department conducted a review of the arrangements for planning, procuring and delivering school building projects. The aim was to improve the efficiency and effectiveness of the processes involved. The review concluded that there was a strong case for a single education infrastructure procurement service which would bring together the specialist skills required in support of the education sector. It would be dedicated to delivering a fit for purpose estate, to ensure that the significant investment to be made transforms our schools estate, and that planning is undertaken within a wider strategic context.

The review identified that many of the specialist activities required are currently split between the department and the education sector bodies. These activities are important to ensure that the estate is planned and delivered effectively and will need to relate closely to the work of the department. The allocation of these specialist functions between the department and the Education Authority will be confirmed in due course.

Supporting education at local level Bringing together, into a regional Education Authority, the functions of five education and library boards with specific geographically defined responsibilities is likely to raise concerns about the loss of local sensitivity in service provision. However, by their very nature, schools and youth services are delivered at local level. The relationship with the local community is strengthened in many ways including local involvement through boards of governors, volunteering, shared facilities and joint initiatives. The growth of the extended school model will continue to enhance the role of schools as learning communities within their localities.

I am committed to reinforcing the links between education and the local community under the new arrangements. This will be achieved by:

Relationship with other government departments The transformation of administration which the RPA will bring forward will take place in the context of increasing recognition of the inter-dependence of public service provision.
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The appointment of a Director of Children's Services is a clear recognition of this. There are other key interfaces which departments must take into account in planning service delivery under the new arrangements. These include:

Moving Forward The new structures represent a fresh start for the administration and delivery of education services. They are not simply a reorganisation of current bodies, but rather a new and fundamentally different approach.

Within this model, the Department of Education will establish the strategic direction for education, setting policy, priorities and standards for schools and youth services, and ensuring the effective and efficient delivery of services by the new Education Authority. The department will set clear standards for the delivery of support and this will be the basis of its commissioning and funding through the new Education Authority. Across the entire education and youth service there will be clear links between the funding provided by the department and the anticipated outcomes.

The department's decision-making will be informed by:

Giving effect to these changes means that virtually all existing education legislation will need to be amended or repealed. The legislation will ensure that boards of governors continue to exercise a large measure of autonomy in the day to day management of their schools. I fully recognise and support the distinctiveness and ethos that boards of governors and staff help foster within schools. I pay tribute to the role of school governors and will protect their influence in these new arrangements.
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To assist with the change process and to ensure an effective transition, the Department of Education will:

The role of the programme board will include:

The programme board will report to the Permanent Secretary of the Department of Education and will be supported by an RPA advisory group, comprising representatives from across the education sector.

Transition The legislative changes will determine the timeframe for putting in place shadow arrangements for the new body. However, I expect that all those involved in education administration will now move quickly to adopt joint working arrangements in preparation for the changes that will result from the RPA implementation.

Conclusion Today's announcement signals a new beginning in how we, in education, conduct our business. We are already in the process of transforming education to meet the needs of young people in a rapidly changing world. It is entirely appropriate that the administration of education should be modernised to ensure that it can provide effective support and improve the delivery of front line education services. The new arrangements will be more streamlined and corporate than at present and will bring greater coherence and consistency in practice.

To do less than the programme of change I have outlined today would be to do a disservice to future generations of young people and their families. Together we can make a real difference, and I urge everyone involved to work collaboratively with DE to ensure a better education service for all.

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