I thank the Chairman and welcome the opportunity to update the committee on progress made in implementing the recommendations of the committee in its report of June 2005 and those contained in the Travers report that pertain to the Department of Health and Children. Before dealing with those recommendations, I think it would be appropriate to say a few words about the Health (Repayment Scheme) Bill 2006. This Bill has passed all stages in the Dáil and Seanad and is now awaiting signature by the President. I acknowledge that the process has taken longer than expected. This was due in the main to the complex and sensitive nature of the issues involved and the need for detailed legal opinion and broad consultation.
The repayments process is expected to commence next month. It is estimated that approximately 20,000 people who are still alive and a further 40,000 to 50,000 estates will benefit. Priority will be given to those still alive. The HSE has been identifying and collating details of repayments due to this group to enable prompt repayments to be made. The overall costs arising from the long-stay charges repayment scheme have been estimated at approximately €1 billion and an appropriate allocation for 2006, which is approximately €340 million, will be made as soon as possible.
I will now deal with the progress made in implementing the recommendations of the committee in its report of June 2005 and those contained in the Travers report that pertain to the Department of Health and Children. In March 2006, I submitted a report to the Tánaiste and Minister for Health and Children which reviewed the various recommendations and described the progress made under each heading. I have arranged for copies of that report to be given to the clerk of the committee and circulated to members and I hope every member has a copy. I have also circulated a copy of what I have termed an "office notice" about special advisers, which was issued in May.
I will highlight a number of the issues dealt with in the March report. There is ongoing contact between the Tánaiste and individual members of the management advisory committee, MAC, on an "as required" basis on particular issues that arise from time to time. In addition, we have put in place a formal structure for meetings. I normally meet the Tánaiste on the morning of each Government meeting; the MAC meets on a quarterly basis with the Tánaiste and her Ministers of State in order to brief them on issues of significance and discuss issues raised by the Tánaiste, a Minister of State or myself; and individual members of the MAC meet the Tánaiste once every two months to brief her on issues within their divisions.
The work programme for the MAC has been restructured, with a planned agenda that includes regular consideration of matters of particular importance, such as monthly reports on the Department's and the HSE's expenditure or Vote and quarterly reports on the legislative programme. A "brief updates" item has been introduced as a regular agenda topic for the weekly MAC meetings. As the title suggests, this is intended to allow each member of the MAC to provide a brief oral update on recent developments in his or her division.
Each MAC member also provides, on a monthly basis, a written list of, and update on, significant issues in his or her division. Copies of the composite document are circulated and discussed at the first MAC meeting of the month. Copies are also provided to the Tánaiste. MAC members are encouraged to include on the MAC agenda items within their individual areas of responsibility in order to brief colleagues and develop a corporate approach to issues. A variety of important policy questions have been tabled and discussed in this way at MAC meetings over the past year. Each division presents its annual business plan to the MAC during the first quarter of the year. This facilitates the identification of important issues and agreement on timelines for action. It also helps to identify cross-cutting issues and reinforces the need for a corporate approach to such issues. The past year has seen significant changes at MAC level in terms of reassignments and lateral mobility.
As members can see from the report I submitted to the Tánaiste last March, I previously agreed with her that it would not be appropriate to appoint external advisers to the MAC. The Public Service Management Act 1997 clearly envisages that responsibility for the management of a Department of State is vested in officers of the Department. This would leave the position of non-officials of the Department on the MAC open to legal uncertainty which would neither be advisable nor conducive to the proper management of the Department. I was conscious also that the committee took a somewhat different view on this issue from that outlined in the Travers report itself. The committee recognised that cross-membership between the MAC and the HSE board would tangle the clear lines of accountability of the heads of both organisations.
There is, of course, a need for excellent conjoint working relationships between the Department and the HSE. In that regard, arrangements for regular meetings between the Tánaiste and Secretary General and the chairman and chief operating officer of the HSE have been instituted, as has a separate programme of meetings between myself and the chief operating officer of the HSE. Arrangements are also in place for quarterly meetings between the HSE and the MAC on service activity and finance issues. This is in addition to the normal ongoing contact at all levels between officers of the Department and the HSE.
The note which issued internally within the Department in May in respect of special advisers, which I have circulated to members, makes two key points. The first is that special advisers are not part of the Civil Service line management and the second is that every effort should be made to keep the advisers briefed on significant issues so that they can do their job.
Following the recommendations in both reports, and in the context of introducing our risk management system, all divisions were asked to review existing procedures to identify if there were any outstanding queries or concerns in respect of their legal basis. None was identified. However, divisions continue to be aware of the need to monitor the situation and identify any emerging legal issues which need to be addressed as a matter of urgency. Any such matters must be brought to the attention of the MAC. It has been agreed that the legal adviser will report to MAC meetings every two months. I understand that my report to the Tánaiste stated that the adviser would report to MAC meetings every three months but this has been changed to two months. It has also been decided to recruit a second legal adviser and we are working with the Office of the Attorney General to give effect to this. All legal advice sought and received by the Department is now routed through the legal adviser. As a result, she will hold a record of all advice and be aware of issues which have a cross-divisional impact. The legal adviser now also circulates copies of legal advice of general relevance within the Department to staff at principal officer level. Another safeguard is that notes or minutes of meetings with the adviser, at which she has given advice, are submitted to her for verification and sign-off before they are finalised to ensure that the interpretation is correct.
Separately, the management of court cases in a more coherent manner is being examined as part of a review currently being carried out by the Department of Finance. I decided to ask the organisation, management and training division, OMTD, of the Department of Finance to carry out this review of certain administrative processes in the Department of Health and Children, namely, court cases, parliamentary questions and correspondence. The purpose of the exercise is to use the OMTD's expertise to identify any weaknesses in our existing systems and to recommend improved arrangements, where necessary. A computer-based centralised records and file tracking system, CRAFTS, has been created and is installed in every section of the Department. It is used to log all official files on a centralised rather than local basis. A new internal correspondence tracking system has been put in place in my office. Similarly, any files, folders, memos or documents transiting through the Minister's office are logged on a separate Minister's office internal correspondence application. A general correspondence tracking system is also operated as part of our quality customer service programme. The OMTD review will provide an outside assessment of how these systems are working in practice.
Risk management, such as business planning, should be an integral part of the normal management process. We engaged Price Waterhouse Coopers to help us formulate a risk assessment model that will meet our needs.
The policy documents to underpin our approach to risk management have been developed. Training, risk assessment and evaluation exercises have been completed and much data has already been input to the model. The resulting risk register identifies risk by category, impact, likelihood, vulnerabilities and actions required and requires a sign-off by the principal officer in charge of the unit concerned. Our proposed risk management system is currently being considered by our internal audit committee.
The period before and immediately after the Travers report was a traumatic one for the Department of Health and Children. However, our response to the recommendations demonstrates that we recognise the importance of learning from what happened. The innovations and changes outlined in my presentation are intended to allow us to deal with issues of singular importance and to improve the routine administration of the Department. They are already influencing our business processes. However, in implementing the recommendations made by this committee and the Travers report, our guiding philosophy must be vigilance and not complacency. There is no end to reform — it is a continuous process that puts an onus on me and the Department to continue trying to make further improvements.
As Secretary General of the Department of Health and Children, my responsibility is to ensure that the Department meets its objectives through the best possible use of our resources, particularly our people. I conclude by stating publicly that I have found a positive attitude towards change among staff in my Department since I joined it last year. I take this opportunity to thank them for their support in helping the Department move forward in a positive way following the events leading up to and after the two reports being considered by the committee today.
