That Seanad Eireann:

• notes the continuing problems and regular crises in the management and operation of our health services, and believes that the HSE is not working;
• further notes that the HSE has failed to meet any of the original objectives set by the government, namely, to make the system more responsive to the needs of patients, to make the system more accountable, and to provide better value for money;
• believes that rather than improving, the situation is in fact getting worse, and that we now have a monolithic system, distanced from the patient, divorced from Ministerial accountability, and driven by budgetary concerns rather than patient need.

Accordingly, Seanad Eireann calls on the government to initiate without delay a recovery plan for the HSE consisting of the following six steps:

1. Establish clear lines of authority, responsibility and reporting within the HSE, with standard-setting at national level and as much day-to-day decision making devolved to local level as possible.
2. Make the Minister for Health answerable to the public through the Oireachtas for all aspects of Health Service policy and delivery, and make the Secretary General of the Department the Accounting Officer for the HSE.
3. Offer a voluntary early retirement, redundancy and re-deployment scheme, as part of the rationalisation of management structures.
4. Give each hospital and each community care area autonomy to spend its budget, allocated according to national norms. Require each hospital to establish a management board.
5. Accountability to the public through Local and National Public Representatives should be at network and community care area rather than regional level and regional structures should be abolished.
6. Each hospital and community care area should be required to establish a patient liaison programme in accordance with recommendation 11 of the HIQA Report on Rebecca O’Malley’s case.

Senators Alex White, Phil Prendergast, Dominic Hannigan, Brendan Ryan, Alan Kelly and Michael McCarthy.