STRICTLY EMBARGOED UNTIL 10.20AM ON THURSDAY 21 MAY 2015

I consider it a tremendous honour to serve as Minister of Health, Social Services and Public Safety in the Northern Ireland Executive.

It also presents a huge challenge.

I don’t underestimate the scale of the task ahead of me.

I know very well how much of the discussion around health centres on the availability of resources.

There is a growing demand for the services our health and social care sector provides. Yet we fall far short in terms of the resources required to meet that rising demand.

While I was pleased as Finance Minister to bring forward a Budget that included an over £200 million increase on expenditure on Health, we are all well aware of the pressures that persist.

We are also increasingly understanding of why, even in a situation where my Department’s Budget has risen by 3.4% this year, financial challenges remain.

The difficulties the health and social care sector in Northern Ireland faces aren’t unique to this country. They are common challenges facing almost every state in the world.

Northern Ireland’s population is growing. The number of people living here has risen by 20% since 1971.

We are also getting older as a nation. By 2061 it is estimated that 53% of our population will be aged 65 or over.

It is great that we are living longer and also – on the whole – living happier and healthier lives but there has also been a related rise in chronic illness with over one-third of Europe’s population estimated to have developed at least one chronic disease by 2010.

We are also well aware of how unhealthy lifestyles are placing untold pressure on our health system. Poor diets and low levels of exercise, for example, are contributing to increases in obesity related diseases and diagnosis of type 2 diabetes, bringing with them additional pressure on services.

Another significant development in recent times is the profoundly positive impact that innovations in genetics, biotechnology and e-health have had on our capacity to survive many diseases. Our ability to conquer previously incurable conditions improves all the time but these technological advances come at a considerable cost.

1 A growing and aging population, a rise in chronic conditions, unhealthy lifestyles, technological advances and scarce resources is a heady cocktail that no health service has truly got to grips with yet. The challenge can sometimes seem insurmountable. Yet, in spite of the difficulties we face, I remain optimistic about the future of health and social care in Northern Ireland.

In his recent report, Sir Liam Donaldson made it clear that he believed that Northern Ireland could have a health and social care service that is amongst the best in the world and that we shouldn’t be satisfied with good enough.

I agree.

If anything, I'd argue that in many aspects of health and social care, we are already amongst the best in the world.

In areas like the excellent work done in this Cancer Centre, in coronary care and in connected health, we can truly say that Northern Ireland is at the cutting edge of healthcare.

Other parts of the world look on with envy at our integrated service with health and social care the responsibility of a single Government Department. Moving towards integrated care featured heavily in the debate on health among mainland parties during the recent General Election campaign. I have no doubt that we can still do more in Northern Ireland to realise the full benefits of our system here.

We can be justifiably proud of what we've achieved in Northern Ireland.

But equally we cannot take our successes for granted or presume that because we excel in certain areas today that will always be the case. The opposite is indeed true. What we are best at is itself in jeopardy in the long term as the aforementioned challenges collide with an imperfect system and structural weaknesses.

Decline is a distinct possibility. Not because of any lack of commitment from our staff. Not entirely because of insufficient resources. But rather because of a resistance to change.

Standing by while our health and social care system slides backwards isn’t an option for me. I am not prepared to see our health and social care system decline and the service our people receive diminish whenever answers exist.

But I know that there are no easy answers. The road to a reformed NHS is paved with difficult decisions.

I completely understand the concerns that talk of reform and transformation in our health service can conjure up in people’s minds.

People can worry that transformation could result in the care they receive being done very differently.

2 Staff can worry that change is code for upheaval in how they work.

There are worries that reform will lead to the closure of facilities.

It is this final point that is the often the most controversial. Report after report – including the Donaldson Report – has concluded that if Northern Ireland wants the highest standards of health and social care then the current configuration of services is not going to work in the future. Some might argue that it isn’t working properly now.

We all know that the facility is far less important than the service that is provided to the patient and that if, in the end, the patient gets the care they need, it shouldn’t matter where that care is given. Yet it does seem that we are too often committed to the structure and not the service.

We can all have attachments to the bricks and mortar of the NHS.

Maternity wards where our children were born.

Hospitals where our sick loved ones were made better.

And care homes where our grandparents lived.

They are - in some cases - generations old emotional ties. I understand them. I have them myself. But they mustn't be allowed to become barriers that inhibit our citizens from getting the highest standard of healthcare.

Health and social care in Northern Ireland cannot stand still. It must move with the times and change. Change, not for change’s sake, but change for the better.

What I want for health and social care in Northern Ireland is clear but it is immensely challenging. I want us to build a world class health and social care service. I want us to be the best, not in just a few areas, but right across the board. It is an ambition that I believe is not beyond our reach.

In the conversations I've had already with health professionals I've been encouraged by their appetite for change. Doctors, nurses and paramedics have said to me that they not only appreciate the need to transform but they want the system they work in to change precisely because they understand that more of the same won’t suffice.

I know that many people will have niggling doubts about what transformation in health and social care means for them and their families. But I don't believe that people aren't willing or able to embrace change. Especially when there are examples of where change has been for the better and the people of Northern Ireland have been the beneficiaries.

Take this Cancer Centre that we are in today.

3 I can recall the opposition at the time to the new cancer network. It was argued that the care provided at Belvoir Park couldn’t be replicated elsewhere.

Today, we are proud of the first rate care that the Northern Ireland Cancer Centre provides and the ground breaking research that is carried out here.

Because of the investment made in this cancer centre, we’ve been able to increase chemotherapy treatments by 10% in the last 3 years.

Stereotactic radiotherapy for lung cancer is now available in this Centre when in the past patients had to travel to England.

Who would dream of going back to the way things were?

Specialist services provided from specialist facilities is self-evidently the best way forward.

It’s what results in the highest quality and safety of care for our citizens.

It is the most effective use of our resources.

And it’s what will make Northern Ireland’s health and social care system world class.

Resisting common sense change.

Turning against best practice.

And opposing evidence based reforms.

Will only deny the people of Northern Ireland the world class health and social care services they deserve.

We need to recognise best performance, harness it and ensure that everyone across Northern Ireland has the same opportunity to receive the highest quality care.

To me, a transformed HSC will be one that embraces innovation.

The very best innovation comes from the ground up. From the doctors, nurses and other colleagues working on the frontline, and I want them to have the freedom and indeed responsibility to step forward and drive change.

Some may argue that previous efforts at transformation have been driven too much from the top, and I've no doubt there'll be an element of truth in that. But equally it cannot be an easy excuse for inaction.

I am placing the opportunity for change firmly with frontline staff.

4 I and my Department will play our part.

We will be to the fore in using the public sector reform architecture that I helped put in place during my time in the Department of Finance. Initiatives like the Public Sector Innovation Laboratory where we can co-design and co-produce new policies with health professionals working with academics and representatives of the Third Sector to develop cutting edge ideas. Other platforms like Ideas Engine where staff across the health and social care sector can suggest solutions to the problems our system faces based on their own invaluable experience.

I want to make it much easier for our staff to be involved in innovation within our health and social care system whether that is big or small.

So I'm saying clearly to those in our health service, the door is open for you to step through it and help transform health care for future generations.

We must all play our part in finding solutions. We are all part of the one team. We all want a world class health and social care sector.

Sometimes I feel the multiple organisations within our health system in Northern Ireland have not been as connected as they might be. That will change under my watch. We need to be more joined up and all pulling in the same direction.

To that end, my Permanent Secretary has this past week written to senior colleagues in the health and social care system to inform them of our decision to establish a Strategic Leadership Group. The role of the Group will be to drive transformational change and ensure the adoption at a regional level of evidence based approaches to service delivery which build on innovation and the adoption of technology. I want to engender a culture of innovation across health and social care in Northern Ireland and I see this Group as an important way of achieving that aim.

I know being Health Minister isn’t always a popular job.

I know I will never meet the idealised vision many have of an NHS in Northern Ireland where every provincial town has an acute hospital. Where there are no waiting lists. And where there is no delay in getting patients new drugs.

And I know that tough choices will be unavoidable and that making some difficult decisions won’t be warmly welcomed.

But whether it makes me popular or not, I will not be deflected away from pursuing my vision of a world class health and social care system for Northern Ireland.

5 I want to see a health and social care sector that has confidence and a sense of direction. One where people and institutions are well connected with each other, trusting, sharing and working together.

I want to achieve an infrastructure of health and social care organisations that are fully integrated and working cohesively across primary, secondary and social care.

I want to ensure that the skills and experience of the health and social care workforce finds its way into policy making and the commissioning of services.

I want to see us in the vanguard of adopting new, innovative approaches and new technologies. To the fore in using the power of data analytics and focusing on prevention and early intervention.

I want to improve our partnership with industry so that patients in Northern Ireland can benefit from the ground-breaking work of local businesses.

But above all I want to see an acceptance of the need for transformation, a willingness to entertain new ideas and to accept change.

Like almost everyone in Northern Ireland, I and my family owe a lot to the dedication, skill and professionalism of our health and social care staff. The NHS is an institution I cherish every bit as much as anyone else and whose founding principles I wholeheartedly support. The absolutely last thing I want to see is that institution deteriorate into a pale imitation of what it once was or what it could be.

In the weeks and months ahead I intend to share my vision for a world class health and social care system with staff, with service users and with the general public. I also want to listen to what people inside and outside of the system think Northern Ireland needs. I want to work with my political opponents in the hope of building a broad consensus on the way forward.

I want to have that conversation with other political parties because it is perhaps the single biggest barrier to change. Almost every expert analysis of the health and social care system in Northern Ireland has broadly agreed the kind of change we need. The real challenge, therefore, is the absence of political agreement on the future of health and social care.

I cannot imagine that there is a solitary politician in Northern Ireland who would not share my aspiration of providing our people with a world class health and social care service. If we do all share that vision then we must work together, build a political consensus around the need for change and agree that difficult decisions must be taken.

We need an open and honest and frank conversation about the future of health and social care in Northern Ireland.

We need to be open about the severity of the challenges we face.

6 We need to be honest about the need to change.

And we need to be frank about the difficult decisions that lie ahead.

I began today by acknowledging the immense challenges my job entails. But in spite of those challenges, I firmly believe that if we embrace reform, make transformation our purpose and resolve to realise change for the better then we can overcome the difficulties we face and deliver a genuinely world class health and social care service.

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