I propose to take Questions Nos. 651 to 653, inclusive, together.
The report of the cross-party Oireachtas Committee on the Future of Healthcare, Sláintecare, identifies four core building blocks that underpin a well-functioning health system. The first of these building blocks is a clear governance and accountability framework. As part of its recommendations in this area, the Committee called for the establishment of a HSE Board, the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.
As the Deputy will be aware, 9 Community Healthcare Organisations (CHOs) and 7 Hospital Groups were established on an administrative basis in recent years to plan and deliver community and acute care services respectively. These structures are not geographically aligned. While significant progress has been made by these structures, there is broad consensus that having separate and un-aligned structures for acute and community care impedes the development of a more integrated health service as envisaged under the Sláintecare programme.
To address these issues, the Sláintecare report recommends the geographic alignment of CHOs and hospital groups to support population based health planning and delivery, the design of the new regional bodies and ultimately the introduction of a form of regional health resource allocation. To support decisions on geographic alignment, the Sláintecare report further recommends “further analysis and consultation …to identify how alignment can best be achieved with minimal disruption to key structures including at community healthcare network level”.
As set out in the Sláintecare Implementation Strategy and the recently published 2019 Sláintecare Action Plan, I am committed to the development of a new system of health structures and governance as called for in the Sláintecare report. The Strategy and the Action Plan set out a number of actions that will lead to the development of a new system of health structures and governance comprising a leaner national centre with responsibility for national planning, strategy and standard setting, complemented by regional integrated care organisations with responsibility for the planning and delivery of services at a regional level.
In line with the Sláintecare report recommendation, my Department undertook a public consultation regarding the geographical alignment of CHOs and Hospital Groups in 2018. In addition, my Department has carried out further detailed analysis work to determine the optimal geographical alignment of CHOs and Hospital Groups which can be achieved with minimal disruption, and which will ultimately be the geographical areas of the proposed new regional integrated care organisations. My Department is finalising proposals in this regard, and I hope to bring these proposals to Government shortly. This will take account of the 2018 consultation process and other planned engagement with key stakeholders, including CHOs, Hospital Groups and academic partners.