Health boards and trusts in Northern Ireland have been set tough targets of reducing waiting lists by 48,000 and cutting the number of patients waiting longer than 18 months by half within the next year.
The targets form part of a new set of priorities set out by health minister Bairbre de Brun, which include sweeping away the internal market completely.
Targeting the province's waiting lists - which currently stand at 29 per 1,000 head of population, compared with Scotland's 17 and England's 20 per 1,000 - is central to the strategy, alongside addressing social need and promoting equality in health and social services. 'I want to see one service, with the user at the heart of everything it does, putting all of its resources into the achievement of common goals, 'Ms de Brun said.
'The targets I have set are challenging but achievable and I shall expect to see everyone involved play a full part in realising them. '
Every health board and council, and the Health Promotion Agency, will be required to have action plans for the 'new targeting special need' policy.
Although no specific funds are allocated for this, the organisations will be expected to build the policy into all spending programmes, skewing resources towards those with greatest need.
They will also have to demonstrate a commitment to equality 'from the highest possible level' and to promote good relations between people from different religious beliefs, political opinions or racial groups.
Among the other top priorities will be:
reducing preventable diseases, ill-health and health inequalities;
ensuring the environment supports healthy living and that recreational facilities are improved;
modernising and improving hospital and primary care;
enabling those who suffer from disability or chronic, mental or terminal illnesses to live normal lives;
promoting the health and social development of children.
As part of the move away from the internal market, boards will have to produce health and wellbeing investment plans from 2002-03 and trusts will have to draw up plans showing how they will implement these.
Boards will also produce service investment plans by 2001-02, setting out the services they intend to secure, and a service delivery plan showing budget plans.
A high-technology assessment group - the equivalent of the National Institute for Clinical Excellence - will also be established. Northern Ireland has a£2. 2bn allocation for health and social services in 2001-02, representing a£161m increase on last year, but the health boards had hoped for£274m.