It’s time for the Health Minister and the Assembly Health Committee to change the direction of the latest health reforms. They need to stop looking at how to change the configuration of those hospital and health facilities that deliver direct patient care and instead to examine the current health system management structures. Perhaps those who are charged with scrutinising the health service should be looking at how fit for purpose the current management structures are and at what value they add to the delivery of services and quality clinical outcomes.

Our politicians should be asking the following questions:

• Do we really need all the structures we have in place at the moment?
• How much of the current health budget is spent on the running costs of each structure?
• Do we need six different Health Trusts, each with its own senior management, middle management and Trust Boards?
• Do we need six local commissioning groups?
• Do we need seventeen Integrated care partnerships?
• Do we need all of the arm’s length bodies with their own management structures and boards?

At a time when waiting lists are growing and services are being reduced can the Department of Health and the Health Minister justify such top-heavy structures and their related costs? Does this represent value for money and more importantly does it deliver better services and clinical outcomes? Services are meant to be available, accessible and local to meet the health needs of the population and these proposed reforms are the polar opposite of that criteria. Perhaps it is now time to look at this structural form of multiplication before changing the current configuration of health service hospitals and facilities.