I propose to take Questions Nos. 15, 154, 162 and 164 together.
At present, my Department has primary responsibility for advising me on issues relating to national policy development and review while the HSE has primary responsibility for the delivery of health and personal social services, including regional and local operational issues relating to the location of particular services.
I believe there is a need for greater clarity about the respective roles of the Minister/Department and of those charged with the delivery of services.
The interim HSE board which I established last May was designed to facilitate greater integration between the senior management teams in my Department and the HSE. I made it clear at the time that I intend to seek Government approval to draft legislation to abolish the board of the HSE and put alternative governance structures in place. My Department is currently preparing policy proposals in that regard for my consideration.
While I would not wish to pre-empt the outcome of this process, I believe we need to make it clear that the Minister is responsible for defining the framework within which services have to be delivered. This would include issues such as funding and financial incentives, service delivery models, and standards relating to performance management, quality and access. Equally, we need to ensure that those charged with the delivery of services have the authority to make the operational decisions required to deliver an agreed quantum of services within budget and in accordance with quality and access standards set at national level. We need to delegate authority as close as possible to the point of service delivery, ensure that such authority is exercised within clear national standards and hold people to account for their performance in that regard.