Tuesday, 27 January 2004

Questions (56, 57, 58)

Liz McManus


170 Ms McManus asked the Minister for Health and Children the steps he has taken to date to implement the recommendations of the commission on the financial management and control systems in the health service; when it will be established; the terms of reference and the programme of work for the interim HSE; and if he will make a statement on the matter. [1884/04]

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Joan Burton


175 Ms Burton asked the Minister for Health and Children the progress made with regard to implementation of the Prospectus report on health structures; when he expects to introduce legislation to provide for the establishment of the four new regional health authorities; the provision there will be for democratic accountability in regard to these new authorities; when he expects that the new authorities will be operational; the steps he intends to take for appointments to health boards in the period between the local elections in June and the establishment of the authorities; and if he will make a statement on the matter. [1888/04]

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Brian O'Shea


192 Mr. O'Shea asked the Minister for Health and Children the progress made with regard to the implementation of the recommendations of the Brennan report; and if he will make a statement on the matter. [1887/04]

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Written answers (Question to Minister for Health and Children)

I propose to take Questions Nos. 170, 175 and 192 together.

The Government's decision on the health service reform programme is based on the recommendations of the following key reports: the audit of structures and functions in the health system from the Prospectus report; the commission on financial management and control systems in the health service from the Brennan report; and the report of the national task force on medical staffing in the Hanly report.

The new structure set out in this reform programme will provide a clear national focus on service delivery and executive management through reduced fragmentation and the creation of clear and unambiguous accountability throughout the system. Phase one of the implementation of the reform programme involved a widespread communications and consultation process and the establishment of 13 action projects to think through and flesh out specific aspects of the programme. The action projects concluded as planned at the end of December. A composite document outlining the main findings is being finalised. Phase two of the reform programme is focused on transition to the new structures. It has commenced at this stage.

Last November I announced the establishment of the board of the interim health service executive and it held its first meeting earlier this month. The interim HSE will be responsible for: recommending the senior management structure for the new executive; recommending regional boundaries and location of regional headquarters for primary, community and continuing care services and appropriate management structures for consideration by the Government; and, within approved parameters, the selection and appointment of a chief executive officer to the HSE and subsequent appointments at senior management level.

The work to be undertaken by the interim HSE is one of four distinct but interrelated strands of activity that will take place under the reform programme during 2004. The other three strands are: the legislative, mainstreaming, human resource and industrial relations aspects of the reform programme for which my Department will continue to have lead responsibility; the work of the acute hospitals review group chaired by Mr. David Hanly; and the ongoing management of the health system and internal preparations for the new organisation and governance arrangements being led by the CEOs of health board and the health boards executive.

The Government has also appointed a national steering committee to oversee the implementation of the work programmes of the four strands. It will provide a co-ordinating forum for actions being led in the respective strands and will ensure overall consistency with the Government's decision. It will report on a regular basis to the Cabinet committee on health strategy, ensuring that the Government is kept informed on all important issues.

The respective roles of the HSE's CEO and board will be made explicit in the legislation to be introduced. I will also continue to be accountable to the Oireachtas in respect of my role and responsibilities and the relevant Oireachtas committees. The Oireachtas Joint Committee on Health and Children and the Committee of Public Accounts will continue to exercise their respective roles.

Regional authorities will not be part of the new structure. I have indicated that I will bring forward proposals for the involvement of public representatives at local level. I shall build on the ideas already outlined for consultation at regional level. Proposals are being prepared in my Department and I have indicated my intention to discuss the matter with the Association of Health Boards at a meeting in the near future.