Dáil Éireann Debate, Tuesday - 29 April 2008
19 Deputy Paul Kehoe asked the Minister for Health and Children her view on the finding of the Health Information and Quality Authority report into the misdiagnosis of a person (details supplied) that the HSE network management system does not have confidence of staff and that new systems have delayed the decision making process rather than facilitate it; and if she will make a statement on the matter. [16339/08]
Amharc ar fhreagra70 Deputy Kathleen Lynch asked the Minister for Health and Children her plans to review the structures of the Health Service Executive in the context of growing concern among the public and health workers that it is not delivering improved care to patients; and if she will make a statement on the matter. [16323/08]
Amharc ar fhreagra161 Deputy Tom Sheahan asked the Minister for Health and Children if she will confirm recent reports from three employees of the Health Service Executive that as part of her reform of the HSE she intends to divide the HSE into four separate authorities with their own individual chief executive officer; and if she will make a statement on the matter. [16165/08]
Amharc ar fhreagraI propose to take Questions Nos. 19, 70 and 161 together.
The Fitzgerald report for the Board of the HSE about the management of events at Portlaoise identified systemic weaknesses of governance, management and communication within the HSE. Arising from that report, I asked the Chairman of the HSE to consider whether the lessons from the report have wider application across the HSE and its proposals to address these matters, as soon as possible. At that time, I also asked the Board of the HSE to immediately adopt an interim serious incident management protocol. I asked the Board to engage closely with this issue through its Risk Management Committee until it was satisfied that serious incidents would be managed to the required standard and to designate one person at national level to ensure that any future reviews are conducted in accordance with the protocol.
At its meeting of the 13th March the Board adopted its current interim Policy and Procedures for Serious Incident Management. The Chief Executive Officer of the HSE has since appointed a senior official to take responsibility at national level for the immediate implementation of this Policy and Procedures.
I am aware that the HIQA report into the misdiagnosis of a particular individual includes various findings and recommendations about the management and governance of acute hospitals. I am confident that these recommendations will also be taken into account by the Board in responding to my request regarding their assessment of the overall situation on governance, management and communication.
I am also aware that the HSE has engaged McKinsey & Co. to undertake some work for it on organisation design.
Deputies may also wish to note that the Commission on Patient Safety and Quality Assurance, chaired by Dr. Deirdre Madden, has been asked to make recommendations on a system of leadership for clinicians and managers which would underpin robust corporate accountability for institutional and clinical performance.
I have no plans to divide the HSE into four separate authorities under their own individual chief executive officers. In my view, the focus should be on improving the operational capability of the existing organisation structure. This requires robust governance/management structures, processes and procedures, incorporating clear reporting relationships and lines of accountability, with permanent top level managers in key posts, good systems of delegation, and a strong sense of corporate identity which permeates all levels of the organisation.
I am aware that the Board of the HSE are addressing these issues and I look forward to receiving their proposals in the near future.
