I propose to take Questions Nos. 1399, 1402 and 1403, 1405 and 1768 together.
The Oireachtas Committee on the Future of Healthcare recommended the alignment of boundaries for the delivery of CHOs and Hospital Groups. Last week, I announced the Government's intention to proceed with these plans based on six regional health areas. This announcement provides clarity on the future shape of the system. It will also ensure that other Sláintecare reforms including the implementation of more integrated care pathways and other system developments (including service planning, capacity planning, funding allocation mechanisms, capital planning, e-Health infrastructure, and back-office systems for data collection, financial management) are designed around the new geographies from the outset.
These boundaries were decided following detailed analysis of patient service usage patterns across the country. This analysis examined patient flows to establish the extent to which hospitals in a given region are serving patients who live in that region. The regions are designed to be as self-contained as possible across the country. This is critically important for the move under Sláintecare to a population-based planning and funding model.
A number of pieces of research, analysis and consultation were undertaken to support the identification of the optimal boundaries of the new regions. This included a review of approaches taken internationally, a review of national policy documents on health reform and previous criteria used in determining regional health bodies, a public consultation process and a detailed analysis of service usage patterns.
While minimal disruption to services was one of the key criteria of this decision, the range of criteria considered included:
1) patient flow/self-containment as mentioned above,
2) critical mass - both of population and the range of health and social care services
3) span of control/manageability
4) alignment with other Government services
6) distance between health services, and
7) academic links.
This announcement signals the Government's intention to design our future health system structure in such a way that will make the Sláintecare vision a reality.