Pat Rabbitte
Question:61 Mr. Rabbitte asked the Minister for Health and Children if the Government is planning a review of the organisation or structures of the health boards; and if he will make a statement on the matter. [22906/02]
Written Answers. - Health Board Review.
The current structures in the health system evolved from a model developed more than 30 years ago. During that time, the size, range of functions and the complexity of managing the system have all grown dramatically. The strengths and weaknesses of the system were discussed during the health strategy consultation process. The main conclusion was that while the system has served well in many respects, some significant concerns remain. These include the need for stronger co-ordination and integration of functions and services, greater consistency in access to services and delivery of services throughout the country and greater clarity around levels of decision-making in the full range of organisations and the requirement for "whole system" effectiveness. The strategy identified an independent audit of organisational structures and functions in the health system as one of a number of actions aimed at achieving the required improved co-ordination, integration and consistency of service delivery.
My Department awarded a contract to perform an audit of the structures and functions in the health system to Prospectus Strategy Consultants on 19 June 2002. The audit is due for completion early in 2003. The purpose of the consultancy project is to determine whether the structures in the health system: are the most appropriate and responsive to meet current and future service needs; constitute an adequate framework for overall governance of the health system; achieve an effective integration of services across all parts of the system; adequately represent the views of consumers in the planning and delivery of services; focus sufficiently upon the principles of equity, accountability, quality and people-centredness and the national goals of the health strategy; and to recommend any changes believed to be necessary as a result of the analysis, including an implementation strategy for any changes proposed.
The audit is critically examining: the number and configuration of existing health organisations – there are more than 50 agencies in the system including health boards and the Eastern Regional Health Authority; their interaction with one another and the Department of Health and Children; the adequacy of governance arrangements; and the scope for rationalisation. The audit is now well under way and has just entered its consultative phase. Its primary focus is to establish the organisational improvements needed to strengthen the capacity of the health system to meet the challenges of implementing the programme of development and growth, modernisation and reform set out in the "Quality and Fairness" strategy document.