In my opening statement to the committee on 25 January, I outlined the progress made in implementing the health reform programme and the considerable levels of service being provided by the health services. Today, I would like to focus my comments on the role of the Department.
The Department and the HSE must work closely together with the shared aim of improving the health and well-being of people. Both have their respective roles to play in meeting this objective. The Department is responsible for advising the Minister on the overall organisational, legislative, policy and financial accountability framework for the health sector. The HSE is responsible for the management and delivery of health and personal social services within the resources made available by the Government.
The Department's key priorities are to put in place a system of performance management which allows the Minister to assess the performance of the health system, particularly the HSE, in its service and financial outturns, value for money, adherence to governance and accountability standards, quality, equity, access, consistency and outcomes. It also must provide a legislative and regulatory framework that helps protect the interests of service users and supports practitioners in working to the highest standards.
The Department aims to provide policy analysis and advice on expenditure acquisition and allocation issues; service development, prioritisation and integration; overall industrial relations, human resources and workforce planning issues; and medium and long-term planning issues. It works with colleagues in other Departments and the social partners to ensure the aim of improving health and social well-being is advanced as appropriate in other parts of the public service. It supports the Minister and Ministers of State in their dealings with the Oireachtas and to ensure Ireland meets its obligations in North-South issues, the European Union, the World Health Organisation and other international bodies. It aims to ensure we have the internal capacity, in terms of structures, people, systems, etc., to equip us to meet our other key priorities.
Like the HSE, and other organisations in the public service, the Department has to manage within the staffing and financial resources made available to us. Although the approved staff complement for the Department is 653, some 120 of this complement belong to the Adoption Board, the General Register Office, the Office of the Ombudsman for Children, the social services inspectorate and the recently established appeals unit dealing with appeals in the repayment of nursing home charges. The approved staff complement for the core Department is just under 530. This includes nearly 70 staff in the office of the Minister of State with responsibility for children and some 50 staff working in the offices of the Minister and the three Ministers of State.
The total current allocation to the Department in 2006 under Vote 39 was about €372 million. However, the bulk of this, some €220 million, was allocated to more than 20 agencies such as the NTPF, Health Research Board, Irish Medicines Board, BreastCheck, Mental Health Commission, Food Safety Authority of Ireland, HIQA, the Office of Tobacco Control and the Office of the Ombudsman for Children. The allocation also includes over €90 million for compensation payments for people affected by hepatitis C, statutory and non-statutory inquiries and legal fees and payments to the State Claims Agency. The balance of some €57 million represents the Department's administrative budget and several other elements.
While the HSE is responsible for operational matters, the Minister remains politically accountable for the performance of the health services. The Department has to ensure there are appropriate systems in place to help the Minister assess and account for the performance of the health system. During 2006, the Department worked with the HSE to improve the format and content of its annual service plan. The 2007 service plan has recently been approved by the Minister and was laid before the Houses of the Oireachtas on 8 February. It outlines more clearly what services are being provided in return for the considerable investment by taxpayers. It also includes material dealing with quality, value for money, consistency, social inclusion and health outcomes.
Pay costs represent the single biggest element of the health sector budget. Increases in pay rates are essentially determined under the national partnership process. Accordingly, the management of employee numbers represents the best way of managing overall pay costs. During 2006, the Department developed and agreed with the Department of Finance a new employment management framework for the HSE which will establish clearer links between service developments, funding and employment.
Legislation is a core function of any Department. The Health (Repayments Scheme) Act, the Irish Medicines Board (Miscellaneous Provisions) Act and the Hepatitis C Compensation Tribunal (Amendment) Act were enacted in 2006. The Health (Nursing Homes)(Amendment) Act was enacted earlier this year. The Health Bill 2006 and the new Medical Practitioners Bill have been published and work is progressing on new pharmacy and nursing Bills, a VHI Bill, an adoption Bill, a public health Bill and an eligibility for health and personal social services Bill.
During 2006, the Department also dealt with approximately 43 statutory instruments, 12 of which transposed important EU directives into Irish law and one which covers the establishment of a statutory complaints procedures under the Health Act 2004 for persons adversely affected by an action either of the HSE or service providers providing services on its behalf.
Policy development and advice is another key area for the Department. During 2006, a number of important policy documents were developed and published. These include by way of example: the publication, as part of the Government's overall disability strategy, of the health sectoral plan on disability; the launch of a new policy for the mental health services, A Vision for Change; the publication of the second national cancer strategy, A Strategy for Cancer Control in Ireland 2006; and the launch in December 2006 of a new nursing home policy care support scheme, A Fair Deal.
The Department also dealt with many other policy and service development issues, often in collaboration with the HSE. These included the following: advising and assisting the Minister during the negotiation of the annual Estimates and budget allocations; the negotiation of the health aspects of the new national partnership programme, Towards 2016; a major new agreement negotiated with pharmaceutical manufacturers; contractual negotiations with medical consultants; the preparation and recent publication of the national pandemic influenza plan; progressing the development of the new national paediatric hospital; and the risk equalisation scheme, which was commenced by the Minister with effect from 1 January 2006.
One of the challenges facing us is the need to join up the health system with other Departments and other sectors of the public service. Better health and social outcomes can often be determined as much, or more, by action taken by other Departments. Obvious examples are housing, education, fiscal and social welfare policy. The Department continues to work with colleagues in other Departments to progress such cross-sectoral issues.
One of our key priorities, like any Department, is to support the Minister and Ministers of State in their parliamentary work. During 2006, the Department dealt with about 6,000 parliamentary questions and 140 Dáil and Seanad Adjournment debates. Over 5,000 ministerial representations were received and staff from the Department attended various Oireachtas committee meetings, either with the Minister or to give evidence themselves. The Department's staff also provided briefing notes and speaking points for the Minister and Ministers of State and attended a large number of meetings involving the Minister and Ministers of State.
Another key priority was to support the Minister in her dealings with other countries and with international organisations such as the EU, WHO and OECD. We also continued to work closely with colleagues in Northern Ireland to maximise the scope for all-Ireland co-operation.
The foregoing gives members a reasonable flavour of the many and varied issues with which the Department deals. Its staff have delivered an excellent service in a complex and challenging area, but the onus is on us to continue to improve our performance. We must improve our analysis and evaluation capacity, review our data sources and information needs, and strengthen our internal systems and procedures. In particular, we must ensure we work in an integrated fashion across the Department and with the HSE and colleagues in other Departments. We will continue to endeavour to respond rapidly and effectively to issues as they arise and to support the Minister and the Minister of State in meeting their responsibilities.