Dáil Éireann díospóireacht -
Tuesday, 26 Nov 2002

Vol. 558 No. 1

Written Answers. - Health Board Services.

John Deasy

Ceist:

379 Mr. Deasy asked the Minister for Health and Children the system in place to ensure that all services provided by each health board area are regulated and operated on the same basis; and if he will make a statement on the matter. [23807/02]

Minister for Health and Children (Mr. Martin)

Under the Health (Amendment) (No. 3) Act, 1996, health boards are required within 42 days of receipt of their allocation to adopt and submit an annual service plan to my Department outlining the planned activity which they will deliver for the funding received. This legislation was put in place to improve accountability in the health services and the resultant service planning framework has led to significant benefits in the management of health service delivery.

The introduction of the service planning framework has provided an opportunity not just to improve financial accountability in the narrow sense, but to enhance the way in which the health services are planned in terms of addressing changing needs and ensuring that the best possible quality of care is provided for the resources available. This has brought an enhanced framework and discipline to the management of the health services. Service plans offer a context for ensuring that policy is being implemented as required, as well as assisting in the consideration of policy and service developments. The need to clearly plan upfront activity for each year and have the plan approved by health boards means that there is a better understanding and joint ownership of the strategic management process throughout the health board system.

An important feature of the service planning process is the ability to enable us to assess how we are progressing towards our goals. Formal review meetings take place at senior level over the course of the year to review the delivery of service plan objectives. By its nature, service planning is an evolving and developmental process that is subject to continuous refinement and improvement. Last year saw a set of performance indicators conjointly agreed between the health boards and the Department being put in place to enable better performance and accountability in the delivery of health board service plans. This is to enable both the Department and the boards reach a better shared understanding of the position in monitoring and evaluating the attainment of service plan objectives by the health boards.

The performance indicators reports are used as an indicative picture of the health board's position in relation to the delivery of the service plans' goals. A programme of work is continuing by joint Department and health board teams to further enhance these performance indicators. In addition, the national health strategy, Quality and Fairness, sets down the development of three to five year strategic plans in health boards, which will further enhance the linkages between service plans and strategic objectives generally.

The Deputy may also wish to note that the Health Boards Executive, HeBE, established on 1 March 2002 enables the health boards to work together on a range of activities which will produce considerable efficiencies and value for money throughout the system. There is no doubt that the structure of decision making, roles and responsibilities within the health system is complex, with many layers and very many intersecting roles. The present structures in the health system evolved from a model developed over 30 years ago. During that time the size, range of functions and the complexity of managing the system have all grown dramatically. The strengths and weaknesses of the system were discussed during the health strategy consultation process. The main conclusion was that while the system has served well in many respects, some significant concerns remain. These include the need for stronger co-ordination and integration of functions and services, greater consistency in access to services and delivery of services throughout the country and greater clarity around levels of decision-making in the full range of organisations and the requirement for "whole system" effectiveness.

The strategy identified an independent audit of organisational structures and functions in the health system as one of a number of actions aimed at achieving the required improved co-ordination, integration and consistency of service delivery. My Department awarded a contract to perform an audit of the structures and functions in the health system to Prospectus Strategy Consultants on 19 June 2002. The audit is due for completion early in 2003. It is now well under way and has just entered its consultative phase. Its primary focus is to establish the organisational improvements needed to strengthen the capacity of the health system to meet the challenges of implementing the programme of development and growth, modernisation and reform set out in the Quality and Fairness strategy document.

John Deasy

Ceist:

380 Mr. Deasy asked the Minister for Health and Children if he will examine the case of a person (details supplied) in County Waterford; and if he will make a statement on the matter. [23808/02]

Minister for Health and Children (Mr. Martin)

The provision of services for people living in County Waterford is a matter, in the first instance, for the South-Eastern Health Board. My Department has asked the chief executive officer of the board to investigate the matter raised by the Deputy and to reply directly to him.