Jim Mitchell
Question:37 Mr. J. Mitchell asked the Minister for Health and Children his plans to reform health boards. [12585/02]
Written Answers. - Health Board Services.
The health boards, established under the Health Act, 1970, are the statutory bodies responsible for the delivery of health and personal social services in their functional areas. They are also the main providers of health and personal social care at regional level. The Health (Amendment) No. 3 Act, 1996, clarified the respective roles of health boards and their chief executive officers by making boards responsible for certain reserved functions relating to policy matters and major financial decisions, and chief executive officers responsible for executive matters.
This legislation is an important milestone in achieving greater accountability regarding expen diture and levels of indebtedness. The adoption of service plans, annual reports and annual financial statements are now deemed reserved functions of each health board and are vital tools in the planning process at regional and national level.
Other recent changes to the system include the establishment of the Eastern Regional Health Authority in 2000 and the provision for a Health Boards Executive, HeBE, to carry out joint functions on behalf of the boards.
The health strategy, Quality and Fairness: A Health System for You, was very forthright in identifying some weaknesses in the health system that needed to be addressed in moving forward. One of these concerned the balance between national and local decision-making; another related to a lack of consistency in the standard and stage of development of services and the less than effective promulgation, at times, of best practice across the regions.
It was accepted as part of the strategy that these issues needed to be addressed and a framework for organisational reform is set out in some detail in chapter 5 of the health strategy. I refer the Deputy to actions 110, 112,113 and 114 set out in the strategy.
Action 110 also refers to the need for health boards to take explicit responsibility for driving change in relation to the new agenda and in providing the best possible value for money.
Action 112 refers to the establishment of the role of the HeBE to carry out certain executive functions on behalf of health boards. HeBE will provide an important avenue for ensuring that the health boards can operate jointly on issues where a national approach to implementing a programme or service is the best way of achieving the objectives of the strategy. As the Deputy is no doubt aware, the Health Boards Executive was launched on 15 February this year, ahead of schedule. Earlier this week I had the pleasure of launching three reports prepared under its aegis – the first fruits of the conjoint working process.
Action 113 refers to the role of the Office for Health Management. The Office for Health Management is currently focused on management development in the health system. Under this action, the brief of the office will be expanded to include organisational development. In this context, it will work closely with my Department to initiate organisational development programmes aimed at co-ordinating structures, strategy, culture, processes and people. Given this office's track record to date in its brief of management development, I have great confidence that soon it will be making its presence felt in relation to the wider agenda.
Action 114, an independent audit of functions and structures in the health system, will provide an opportunity to critically examine the number and configuration of existing health organisations, their interactions with one another and with the Department of Health and Children; the adequacy of governance arrangements; and the scope for rationalisation.
I am placing an emphasis on a reform agenda which is focused not on "visible" change – change for its own sake – but change which is aimed at providing a responsive, adaptable health system which meets the needs of the population effectively and at affordable cost. The tendering process for the audit of functions and structures is currently under way and my aim is to have consultants appointed and the project commenced at the earliest possible date.