Dáil Éireann Debate, Wednesday - 26 May 2004
60 Mr. Murphy asked the Minister for Health and Children when he will put forward proposals to address the issue of democratic input into the new health structures; if they will be put on a statutory basis; and if he will make a statement on the matter. [15424/04]
Amharc ar fhreagraThe health service reform programme is based on the Government's decision of June 2003. This decision was based on the audit of structures and functions in the health system carried out by Prospectus and the report of the commission on financial management and controls in the health service. Both reports identified organisational improvements needed to strengthen the capacity of the health system to meet the challenges of implementing the programme of development and reform set out in the health strategy document, Quality and Fairness: A Health System for You.
The health service reform programme has been brought to the attention of all members of health boards/regional authority. The Government agreed that health boards and the Eastern Regional Health Authority will be abolished as part of the overall health reform programme. The Health (Amendment) Bill 2004 is interim legislation which provides for the abolition of the membership of the seven health boards, the Eastern Regional Health Authority and the three area health boards. It also provides for the abolition of the distinction between reserved and executive functions, with the assignment of those functions currently designated as reserved functions to the chief executive officers of the boards and authority or the Minister for Health and Children, as appropriate. The Bill's publication represents a further phase of the implementation of the reform programme for the health services and is a clear demonstration of the Government's commitment to implementing the proposals in the reform programme, which include the establishment of the Health Service Executive on a statutory basis, scheduled for January 2005.
The Government accepted that there is a need to strengthen existing arrangements with regard 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 aware that concerns have been expressed regarding the issue of public participation within the restructured health system. I have already indicated my intention to bring forward proposals to provide opportunities for democratic input in the context of the new structures. I have given some consideration to the most appropriate mechanisms to support the development of appropriate interfaces at regional and local level between locally elected representatives and the Health Service Executive, with a view to including provisions for these mechanisms in the legislation currently being drafted.
The provisions are likely to include establishment of a series of regional fora to facilitate local representatives in raising issues of concern about health services within the region with the new executive. These fora would allow local representatives to comment on and raise issues related to the development and delivery of health services locally. Membership of the fora would be based on participation of a small number of nominees in respect of each local authority in each regional forum. Members of the fora would also have the facility to raise particular issues with the executive.
My overall objective in putting in place such arrangements is to ensure that the voice of local public representatives will continue to be heard on the development of health services. These mechanisms would be designed to complement and reinforce the role of the Joint Oireachtas Committee on Health and Children in reflecting the views of public representatives in the ongoing oversight of the health system.
The health strategy set as one of its objectives greater community participation in decisions about the delivery of services. The Health Boards Executive, in association with my Department, issued guidelines to the health boards on community participation which set out the principles and framework for structures for such participation. To date, most of the health boards have set up consumer panels that deal with a wide range of issues, such as development and delivery of services. Two boards have also established regional advisory panels for older consumers and their carers. It is my intention that these structures will be established on a statutory basis in a Bill which I intend to bring before the House later this year.
