I propose to take Questions Nos. 59 and 76 together.
The implementation of the health reform programme, which includes both the Prospectus and Brennan reports, is currently under way. The current phase of implementation consists of four distinct but inter-related strands of activity which will take place during 2004. These strands are: the work of the interim health service executive, HSE, leading to the establishment and the orderly transfer of functions to the HSE; aspects of the reform programme for which the Department of Health and Children has lead responsibility, including legislation, the establishment of HIQA, governance, streamlining of agencies, HR/IR, financial management/service planning, etc.; the work of the acute hospitals' review group chaired by Mr. David Hanly; and the ongoing management of the health system and internal preparations for the new organisation and governance arrangements being led by the chief executive officers of health boards and the health boards executive.
A number of key bodies central to the reform programme are now in place. The national steering committee, NSC, charged with overseeing the implementation of the work programme of the four strands has been established. It provides a co-ordinating forum for actions being led in the respective strands and will ensure overall consistency with the Government's decision. It is to report on a regular basis to the Cabinet committee on the health strategy, ensuring that the Government is kept fully informed on all important issues. The first meeting of the NSC took place on 16 February.
I announced the establishment of the board of the interim HSE last November and the board has met on a number of occasions. The interim HSE is now established as a statutory body on foot of S.I. 90/04. Under the establishment order, the interim HSE has been given the task of drawing up a plan for the Minister's approval for: the establishment of a unified management structure for the proposed new health service executive; the integration of the existing health board structures into the new health service executive; the streamlining of other statutory bodies, identified in the Prospectus report, to be incorporated in the new structure; the establishment of regional boundaries for the delivery of primary, community and continuing care services; the establishment of procedures to develop a national service plan for the delivery of health services; the establishment of appropriate structures and procedures to ensure the proper governance and accountability arrangements for the proposed health service executive; and the appointment of a chief executive officer.
The interim executive has also been given the task of making the necessary preparations to implement this plan, subject to ministerial approval, so as to ensure as smooth a transition as possible from the existing health board structure to the new health service executive structure.
The Deputy should note that there will not in fact be four regional health boards. Instead, there will be a single unitary structure, the HSE, which will be supported by three pillars, one of which will manage the delivery of primary, community and continuing care services. This pillar will be organised through four regions for administrative purposes. I have already clarified this in the House. Regional health authorities, as referred to in the question, will not be part of the new structure.
There is a need to strengthen existing arrangements in relation to consumer panels and regional co-ordinating/advisory committees in representing the voice of service users. These structures incorporate patients, clients and other users, or their advocates. They will work to provide a bottom-up approach to understanding the needs of service users at a regional planning level. These existing models are at different stages of development and will continue to be enhanced. These mechanisms will serve to bring the patients/clients' views and inputs to bear in the decision making process.
I am conscious of the concerns to ensure that there is adequate governance of the new structures in a radically restructured health system. I have agreed to bring more detailed proposals to Government on the representation arrangements shortly. I am satisfied that the new arrangements, combined with the introduction of system-wide best practice governance and accountability systems, will ensure a stronger more effective health system and an improved health service for patients and clients.
Last week, I referred to the Health (Amendment) Bill 2004 in the House which I expect to be in a position to publish shortly. I also referred to my plans for legislation to establish the HSE to replace the Eastern Regional Health Authority and the health boards and it is my intention is to have this legislation introduced by December 2004 so as to have the HSE in place in January 2005.