Skip to main content
Normal View

Dáil Éireann debate -
Tuesday, 25 Nov 2003

Vol. 575 No. 3

Written Answers. - Health Service Reform.

Seán Haughey

Question:

247 Mr. Haughey asked the Minister for Health and Children the main elements of his plans for health reform; and if he will make a statement on the matter. [28223/03]

I have already outlined in detail to the House the background to the health service reform programme. The Government's decisions in this regard are based on the recommendations of three key reports: the audit of structures and functions in the health system, the Prospectus report; the commission on financial management and control systems in the health service, the Brennan report and the report of the national task force on medical staffing, the Hanly report.

The key elements of the reform programme include a major rationalisation of existing health service agencies to reduce fragmentation. This involves the abolition of the existing health board-authority structures, the reorganisation of the Department of Health and Children to ensure improved policy development and oversight, and the establishment of a health services executive which will be the first ever body charged with managing the health service as a single national entity. The executive is to be organised on the basis of three core divisions: a national hospitals office, a primary, community and continuing care directorate, and a national shared services centre. Other elements include the establishment of a health information and quality authority to ensure that quality of care is promoted throughout the system; the modernisation of supporting processes, service planning and management reporting, etc. so that they will be in line with recognised international best practice; the strengthening of governance and accountability across the system; the reduction of non-consultant hospital doctors working hours in line with the EU directive; and the reorganisation of the acute hospital sector. The programme's priority focus is improved patient care, better value for taxpayers' money and improved health care management.

I have previously outlined in the House the activity already completed or under way in relation to the implementation of the programme. The Government agreed that to succeed it would be necessary to clearly set out the Government's vision of reform to all in the existing health system, including board members, staff and staff representatives. This engagement was undertaken as a vital first step in the implementation process. This is the process on which we have been engaged during the last number of months. The Secretary General and I briefed every senior manager of every agency in the system in the days after the Government's decision. There followed a visit to every health board area, meeting large numbers of staff and board members.

The Department commissioned the office for health management to conduct an information and consultation exercise reaching as many people and agencies as possible in the system. More than 20,000 staff were directly engaged with over the summer months and into September. The draft report of the OHM is now completed. Overall co-ordination of the change programme is supported by a project officer led at assistant secretary level which reports to the Secretary General of my Department.

Output to date from the project office includes a draft project plan for the reform programme, identifying manageable phases of implementation and the establishment of 13 action projects to advance specific elements of the programme by the end of the year. The work of these action projects is well under way at this stage. I am satisfied that the preparatory work on which we have been engaged has been undertaken with the appropriate degree of professionalism and urgency. This programme affects every aspect of the health system and everyone working in it – close to 100,000 people. If it is to have a lasting impact, particularly for patients and clients, it must be professionally planned and executed. I am more than satisfied that the planning and initial consultation phase we have undertaken will pay dividends in the longer run and that the reform programme is being advanced in the appropriate manner and pace for change of this order.
The establishment of the health service executive on a statutory basis will require legislative changes. Work has commenced on the preparation of this legislation, which will provide the statutory basis for the establishment of the new health service executive and related structures. The new legislation will also incorporate other legal changes required and my aim will be to introduce the necessary legislation next year. It is my intention that, assuming the legislation can be advanced in a timely fashion, the health service executive will be in place on a statutory basis in 2005.
The Government decision on funding of the reform programme provided that funding in 2003 would be met from within the existing allocation. This has been achieved. Provision for 2004 has been the subject of discussion during the Estimates process. I am satisfied that there will be adequate provision for the advancement of the programme, including the funding of the interim health service executive in 2004.
The Government has agreed on the appointment of an executive chair for the interim health service executive and the formalities of that appointment are currently being worked through. In parallel, I am in the process of inviting other individuals with the required competencies to become members of the board and I expect to have that process completed by the end of the current week. I will be making a public announcement on the appointment of the board at the earliest opportunity. Following on the appointment of the board, I will bring proposals to Government on the membership of the national steering group.
Top
Share