Health Services Provision
The principal legislation on Health Services in Northern Ireland is the Health and Social Services (NI) Order 1972. There have been a number of amendments, including significant reforming Acts such as the Health and Personal Social Services Act (NI) 2001 and the Health and Social Services (NI) Act 2009.
It is the duty of the Department of Health (and Social Services) to provide and secure the provision of integrated health services in Northern Ireland designed to promote the physical and mental health of the people through prevention, diagnosis, and treatment of illness, as well as to provide and secure the provision of personal social services designed to promote the social welfare of people in Northern Ireland. The Ministry is also responsible for discharging its duty to secure effective coordination of health and personal social services.
The Department is tasked with providing hospital accommodation, including psychiatric hospitals, as well as premises other than hospitals where health facilities are to be provided, and medical, nursing, and other services, whether in accommodation, premises, or in the home of the patient or elsewhere.
The Department may permit qualified individuals to use facilities provided for private medical practice, primary dental services, general dental services, ophthalmic services, and pharmaceutical services on terms determined by the Department. This permission applies to doctors, dentists, ophthalmic opticians, pharmacists, etc. The Department may make arrangements, to the extent it deems necessary, for the prevention of illness, care of persons suffering from illness, and after-care of such persons. It may also impose appropriate charges for these services.
The Department is obligated to make arrangements, to the extent it deems necessary, for the care, including medical and dental care, of expectant and nursing mothers, as well as young children. Charges may be levied for these services.
Additionally, the Department shall provide medical inspection of school children and young persons at appropriate intervals who are in full-time attendance at grant-aided schools. This includes dental inspection, supervision, and education. Comprehensive facilities for medical and dental treatment are to be made available. Schools may be required to maintain records and submit reports as necessary.
The Department may, with the consent of the owners of an independent school, on such financial and other terms as agreed, make arrangements for the provision of medical and dental inspection and services.
The Department is to make provision for ancillary services including ambulances, laboratory services, diagnostic radiology, blood transfusion, blood tests. It is to make arrangements for vaccination and immunization.
The Department is to make arrangements, as it considers necessary, for advice, examination, and treatment of persons in relation to contraception and the supply of contraceptive substances and appliances.
The Department may sponsor and provide facilities for undergraduate and post-graduate clinical teaching and research. It may disseminate information regarding health promotion, maintenance, and illness prevention.
The Department may make arrangements for the provision of the services by other bodies on such terms as it may agree. This may include allowing other bodies to use the Department’s facilities, premises, goods, equipment, materials, staff, etc.
In exercising its general functions, the Department is to make available advice, guidance, and assistance, and make arrangements for the provision of facilities as it considers suitable and adequate, including the provision of residential or other accommodation, home help, and laundry facilities. It may assist other bodies and organizations in providing such services.
The Department may make regulations regarding the provision of primary medical and personal services and dental services. It may provide for the conditions for qualification and experience to be satisfied by persons providing primary medical services, dental practitioners.
They may provide for the circumstances in which patients may be accepted or declined and determination of responsibility for a patient. It may provide for the entry of a general medical services contract on prescribed terms. Persons providing the services, if so requested, are to provide for the rights of patients to choose between service providers.
Provision is to be made by regulation in relation to the choice of dental practitioner. The Department was to establish a Health and Social Services Board for such areas as it determines. It is to be constituted as set out in the schedules to the regulation. The Health and Social Services Boards are to exercise on behalf of the Department such functions in respect of administration of health and personal services as the department directs. It is to provide facilities and accommodation for persons training with a view to qualification for registration as nursing and midwives. It is to exercise, in the Department such functions in respect of the administration of health and personal social services, as is directed.
Health and Social Service Board is to submit a scheme for the exercise of its functions. It is to accord with regulations and directions by the Department. The Department may approve or modify a scheme.
Health and Social Services Boards may constitute joint committees with the consent of the Department. The Department may by order establish for the area of Health and Social Services Board or for two or more Boards, a University Liaison Committee. The purpose is to advise the Boards on the administration of the health services in the area in relation to the provision of facilities for undergraduate and post-graduate clinical teaching or for research and for the purpose of advising the Board and universities concerned on matters of common interest.
The Department may appoint a central advisory committee for any profession or professions engaged in the provision of services by it. It is to advise the Department on the provision of services in relation to which the committee acts. The Department may establish other advisory committees for the purpose of advising the department on various areas.
The Northern Ireland Central Services Agency for the Health and Social Services is established. The Department may provide invalid carriages for persons appearing to be suffering from a physical defect or disability, at their request and may provide them with a vehicle other than an invalid carriage. They may adapt a vehicle for the purpose of making it suitable; maintain, repair; insure, etc. They may provide structures for keeping the vehicle.
They may make payments by way of towards costs incurred by persons in respect of the vehicles to enable mobility.
The Department may authorize accommodation and services in hospitals be made available, for patients who undertake to pay, in respect of services provided. It shall only do so if it does not interfere with the performance of the duties of the Department and will not operate to the disadvantage of the person seeking or affording admission or access to accommodations, other than under this provision.
The Department may provide accommodation in single rooms or small wards to such extent and on such charges as the Department may determine.
The Department may make regulations in respect of the examination and cleanliness of pupils in grant-aided schools. They may provide for exclusion from schools of pupils where examination or cleansing cannot immediately take place.
Arrangements may be made for the provision of accommodation and premises maintained by a voluntary organization. Payments may be made at rates to be determined under the arrangement. Where arrangements are made to provide accommodations, the person for whom accommodation is provided, shall refund, may be obliged to refund part of the payments.
The Department shall make arrangements for the purpose of securing necessary care and attention for persons who are suffering from grave chronic disease, being aged, infirm, or physically incapacitated, or living in insanitary conditions; and unable to devote themselves, or receive from others, proper care and attention. They may be able to remove to suitable premises. This may be applied to persons suffering from mental disorder, and references to hospital may be one approved under the mental health legislation.
The Department shall cause for the burial or cremation of bodies of deceased persons, who have been accommodated under health legislation prior to their death. They may recover the cost and expenses from the estate. Part or all of the cost may be waived.
Personal services may be provided to different persons to different extents, as is determined to be expedient. Services may be made available to persons not ordinarily resident in Northern Ireland to such extent as may be prescribed.
The Department may provide training for persons in the health and personal social services sector. This may be done directly in Great Britain or by a voluntary organization, where approved. They may facilitate training, provide material, premises, etc. They may make grants towards fees or expenses or defray or contribute towards the cost of maintenance of persons undergoing training.
The Department may, by regulations, provide for the payment by the Department or a trust in accordance with prescribed scales and on prescribed conditions of traveling and out-of-pocket expenses necessarily incurred by any person for the purpose of availing of services and of persons accompanying them. Provision may be made for contribution or reimbursement.
A Department has powers to acquire land compulsorily for its purposes or by agreement. They may enter land with a view to considering possible acquisition. Procedures apply to the exercise of the power of entry.
The Department may at reasonable times enter and inspect any premises (other than premises registered under Health and Personal Social Services (Quality, Improvement, and Regulation) (NI) Order 2003) in which services are, or are proposed to be, provided by any person or body under arrangements with the Department.
Persons entering may make such examinations into the state and management of the premises as they see fit; inspect records and require that information be furnished. They may interview persons residing at the premises for the purpose of investigating complaints or if they have reason to believe services are not being provided satisfactorily. They may require the production of records, documentary and electronic.. There are conditions applicable to the examination of medical reports.
If the Department is satisfied after investigation that any list of persons providing, medical practitioner, dental practitioner, ophthalmic pharmaceutical or other services, is such as not to secure the adequate provision of the services or for any other reason. Any considerable number of persons are not receiving satisfactory services, they may make such other arrangements as they approve or as they believe necessary.
Where the Department is of the opinion that an emergency exists and it is necessary to do so, to secure the effective continuance of any services under health and personal social services legislation, the Department may direct that functions conferred on the statutory bodies shall during the period of emergency be performed by some other body or person as the Department may specify.