Dáil Éireann díospóireacht -
Tuesday, 30 Sep 2003

Vol. 571 No. 1

Written Answers. - Health Service Reform.

Conor Lenihan

Ceist:

849 Mr. C. Lenihan asked the Minister for Health and Children the timetable for the completion of his plans to reduce the number of health boards; and the number of jobs that will cease to be as a result of the savings achieved due to the reduction in the level of duplication of services. [19951/03]

Conor Lenihan

Ceist:

851 Mr. C. Lenihan asked the Minister for Health and Children the figure for the savings he hopes to achieve by carrying to completion his intended reforms of the health service. [19953/03]

Minister for Health and Children (Mr. Martin)

I propose to take Questions Nos. 849 and 851 together.

The purpose of the reform programme is to remove obstacles to the delivery of the national health strategy, Quality and Fairness: A Health System for You, and to achieve: a new structure which will provide a national focus on service delivery and executive management of the system; a reduction in fragmentation and duplication of effort, thereby making the system more manageable and efficient; a far greater consistency between the level and types of services provided in different parts of the country; and the alignment of responsibility and accountability throughout the system.

Both the Brennan and Prospectus reports speak of the likelihood of savings in the implementation of their respective recommendations. However, the Prospectus report also states that it is extremely difficult to accurately predict the true financial impact of programmes of this scale. Our primary purpose is not to make savings but to ensure that the maximum possible of the resources allocated to the health sector reach the service user. What savings can be made, will be identified and appropriately redistributed.

The Minister for Finance has already made a statement in relation to a possible reduction in the overall number of staff in the system. He indicated that with the reduction in the number of agencies and the general streamlining in management structures some jobs will no longer be needed in the new system. This does not imply that there would be redundancies. It is anticipated that changes will largely be absorbed by natural wastage and redeployment. The intention is that freed up resources can be put into the improved delivery of front-line services.

It is important to note that the reform programme is not only about structural change but about improving processes such as planning, financial management and control and the linking of funding and planning in a coherent way. Existing services will continue to be delivered in a coherent and standardised manner, through the new organisational structures that are being adopted by the Government.

It is likely that it will take between 18 months and two years to carry through all of the proposed changes to their full statutory basis. However, it will be possible to effect many changes on an administrative basis in the meantime. I would hope that all of the key elements will be in place within three years. However, it must be recognised that change of this order must be carefully planned and organisational development processes carefully managed to fully bed down the new structures. The management of the transition to the new structures will have to go beyond the establishment of the new bodies to support the successful and effective development of the new structures internally. In relation to activity since the Government's announcement on 18 June, the following should be noted. A structured feedback process has been undertaken by the Office for Health Management on behalf of the Department of Health and Children since Governments announcement. This was a large undertaking involving more than 20,000 staff. The OHM will be reporting to the Department very shortly. Detailed work has also been going on to scope and plan the programme of change agreed by Government. Terms of reference and membership of action projects to advance specific aspects of the programme are almost finalised. A project office to support the programme is currently being established with key staff to lead and support the development of the programme already appointed.

A national steering committee and board for the interim health service executive are to be appointed in the coming weeks. I am currently considering possible nominees and will be reporting to Government shortly following consultation with my colleague, the Minister for Finance.

Change cannot be achieved by diktat from the centre; it will require an enormous effort and belief on the part of all of those working in the system at present. The need for constant communication around a change process on this scale is well acknowledged and formed a strong recommendation in the Prospectus report on the audit of structures and functions in the health system. The early feedback has been that this first step in informing, and seeking feedback from staff has been extremely well received and will have dividends in the longer term. I am convinced that the preparatory work currently nearing completion is well worth getting right and is key to the future success of the reform programme.