A key stepping stone towards the introduction of Universal Health Insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of integrated groups. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. Reform across the three domains of access, quality and resources is not achievable unless there is real clinical and managerial accountability at hospital level.
The work on hospital groups is not about downgrading hospitals. It is about the bringing together groups of hospitals to form single cohesive entities to allow maximum flexibility in management, budgets and service delivery. Hospital groups will be established on an administrative basis pending the legislation required to set up hospital trusts by 2014. Before those trusts are established the make-up and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.
Last June I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. The Strategic Board is composed of representatives with both national and international expertise in health service delivery, governance and linkages with academic institutions. A Project Team was established to make recommendations to the Strategic Board on the composition of hospital groups, governance arrangements, management frameworks and linkages to academic institutions.
The Project Team is currently finalising a Report on the recommendations outlined above, taking account of the observations and comments made by the Strategic Board at their meeting on 14th November. It is anticipated that this work will be completed within the next few days. Upon completion, the finalised Report will be submitted to me and I will then bring it to Cabinet. The composition of Hospital groups will be a Government decision, taking into account the recommendations of that Report.