Dáil Éireann díospóireacht -
Thursday, 24 Oct 1991

Vol. 411 No. 6

Adjournment Debate. - Proposed Reorganisation of Eastern Health Board.

Mr. Byrne

First, I would like the Minister to comment for the record so that we can eliminate once and for all the farce that takes place daily on the Order of Business when what is Government-planned legislation announced outside the House must be raised in the House to enable us to debate these issues.

Clearly the Government and Minister have committed themselves to restructuring the health services, to replacing the Eastern Health Board with a Dublin regional health authority.

The reason I sought to raise this matter this evening was to explain to the Minister that the deadline he has set for receipt of submissions, that is Friday, 1 November 1991, is much too early for many, if not all of the hospitals, voluntary and non-voluntary, for the Eastern Health Board along with the large numbers of religious hospitals and so on, and indeed, the voluntary agencies. For example, the Eastern Health Board only received the Minister's letter of instruction on 1 October 1991. The board have not met to finalise their submissions and will not meet until 7 November 1991, six days after the deadline set by the Minister.

As a member of the board of Our Lady's Hospital for Sick Children, Crumlin, I appreciate, as I am sure will the Minister, that a tremendous amount of thought, consideration, consultation and so on is required for the hospitals and other agencies to fully prepare their responses. In the course of the Minister's letter of instruction dated 27 September, 1991 to the Eastern Health Board he had this to say:

As the first stage in this consultation process I am now inviting your board to make a written submission in relation to the implementation of the Government decisions which are set out on pages nine and ten of the address. I should stress that the Government's consideration of the broad principles of the reorganisation is now complete and submissions should concentrate on the issues which you would wish to see taken into account in preparing the detail of the legislation and the subsequent implementation.

A lot of work must be undertaken by these hospitals and by the Eastern Health Board to prepare their submissions. The Minister's proposals are hugely complex and their implications for those involved in administering and delivering the health services are equally complex. One month is not enough time to analyse the recommendations of the Kennedy group report given that that report is inconclusive and vague in relation to, for example, the type of structure they envisage will replace the health board. Given that the report, as submitted, envisaged that the Tallaght Hospital would be in situ in one of the five management areas, it must be extremely difficult for people to know how to make their submissions to the Minister.

I should like the Minister to give a commitment that he will extend the 1 November closing date for receipt of submissions so that the recommendation's can be properly analysed and there can be more consultation by those who will be affected by their implementation. As I have said, nobody knows how the regional board will be structured or who will be on the five management boards. Information on the subsequent districts which will be set up under the new structure is also very vague. No matter what structure is set up, I think politicians from all political parties will demand proper and full public representation on the boards. In order that everyone will have an opportunity to make their submissions I ask the Minister to extend the 1 November closing date.

Minister for Health (Dr. O'Hanlon)

As the Deputy will be aware, I announced the Government's plans for the reorganisation of the health services in the Eastern Health Board area on 18 September last. Legislation will be necessary to provide for a single new authority to replace the Eastern Health Board. The new authority will be responsible for all health and social services in their area of operation.

The next phase of the consultation process has now been initiated following the announcement of the Government's decision. My Department have written to 133 organisations inviting them to make written submissions. I have asked them to try to have their submissions in relation to the issues of detail I have outlined above sent in by 1 November next. It will take time to process the many submissions I expect to receive and any which arrive after that date will also be accepted. I am aware that the Eastern Health Board will consider the matter at a special meeting on 7 November. Of course, we will take their views into account when we receive them in the Department.

I believe the timescale is acceptable. It is a question of balance. Deputies opposite often come in here and accuse us of prevarication and not moving rapidly enough. The recommendations of the Kennedy group have been available for a long time and I am sure have been studied by all the interested agencies. Indeed many of them were represented on the hospital side during the Kennedy group review. It is a question of balance between trying to move on with the legislation — I am anxious that we move ahead with it — and ensuring that people have the opportunity for proper consultation. Of course, the receipt of these submissions will not in any way mean the end of the consultation process. Consultation will be ongoing with the various interests concerned, both in the context of the finalisation of the proposal and also their subsequent implementation.

I want to assure the Deputy that we will respect the voluntary status of a number of the agencies. I respect the contribution they have made to health care and it is the Government's intention that their voluntary status will be respected. As the Deputy knows, the services will be administered through five administrative areas, two on the north side and three on the south side. I would not like the Deputy to make out that it is more complex than it really is. This will be a management authority which will manage all health and social services in the Dublin, Kildare and Wicklow areas. At present we are spending £500 million on such services, £231 million of which is paid by the Eastern Health Board. The new authority will be responsible for the management and administration of all the services, having regard to the voluntary status of a number of agencies.

From the very start of this review of structures I have insisted on the widest possible consultation and this will continue to be the case until the new arrangements are in place. The deadline for written submissions, while flexible, is necessary if we are to maintain progress. As I have explained, these submissions represent only one aspect of a long process of consultation. I firmly believe it is important that those who will be affected by the reform, especially the voluntary agencies, are fully involved in it and understand what we are hoping to achieve. In this way I believe that it will meet with their full support and co-operation.