A clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for 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 6 Hospital Groups are in place on an administrative basis to plan and deliver community and acute care services respectively. 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 underpinned by population based planning, as envisaged under the Sláintecare programme.
In this regard, the Sláintecare report recommended that “further analysis and consultation should be undertaken to identify how alignment can best be achieved with minimal disruption to key structures including at community healthcare network level”.
As a first step in this, I announced the areas for six new regional bodies last week. This is an important step in signalling the future shape of the health service.
In parallel, work is progressing in my Department on the development of detailed policy proposals on reconfiguration of the HSE, including the establishment of regional health bodies. These regional bodies will have clearly defined populations and can plan, resource and deliver health and social care services for the needs of its population. It will result in improved accountability and governance in terms of finance and performance. It will also empower front-line staff and allow for the devolvement of decision-making power from the HSE to each local region.
Equally, I am committed to this new structure involving a more streamlined national centre and a sharing of expertise. It will also avoid duplication of personnel and support functions between CHOs and Hospital Groups.