I propose to take Questions Nos. 219, 241 and 243 together.
The Galway/Roscommon University Hospital Group was established on a pilot basis in January 2012. This was in response to budgetary and service issues in relation to Galway and the movement of services between Roscommon and Portiuncula hospital in line with the principles of the smaller hospitals framework, that service should be delivered as close to a person’s home as possible. This is commensurate with the need to ensure quality and safety in service delivery such that more complex work generally needs to be carried out in larger hospitals. The Group consists of University College Hospital, Galway, Merlin Park Hospital, Portiuncula Hospital, Ballinasloe and Roscommon Hospital. The Group was established on a co-operative, administrative basis as significant legislative work is required to allow hospitals to form Hospital Trusts.
In June 2012 I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. A Project Team was tasked with developing criteria to assist my Department in the development of policy in relation to the composition of hospital groups, governance arrangements, current management frameworks and linkages to academic institutions. The Team carried out a comprehensive consultation process with all acute hospitals and other health service agencies as well as reviewing a significant number of written submissions. The experiences of both the Galway/Roscommon University Hospital Group and of the Mid-Western Hospital Group, which were related to the project team as part of that consultation process, were both useful and informative.
Work is nearing completion on the draft report on the wider issue of hospital groups. Prof. John Higgins will submit that report to me in early February; I will then bring it to Cabinet for decision. The Government will then decide on the initial make up of hospital groups which will be established on an administrative basis pending the legislation required to set up hospital trusts by 2015. Before those trusts are established the composition and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed. As such I cannot comment at this time on the final composition of the new Hospital Groups.
The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. Under the Programme for Government 2011-2016, the Government committed to developing a universal, single-tier health service, which guarantees access to medical care based on need, not income. On foot of this commitment the Government will introduce a system of Universal Health Insurance (UHI). The development of independent not-for-profit hospital trusts is a key stepping stone to this new system.
Each Hospital Group will have a single consolidated management team with responsibility for performance and outcomes. It is intended that non-executive Boards, consisting of persons with expertise in key competencies such as clinical/business/legal/medical academic/patient advocacy, will oversee each Hospital Group management team and will have responsibility for decisions in relation to services in all hospitals in the Group. The Galway/Roscommon University Hospital Group has gone some way towards realising the governance arrangement which will be recommended by the Report with the appointment of Mr. Noel Daly as chairperson of the Board in May 2012. Mr. Daly is former Chief Executive of An Bord Altranais and he has also served in senior management posts in the health services in Ireland and in the UK.
On 29th January 2013 the HSE established an interim Board on an administrative non-statutory basis, pending the establishment of Hospital Trusts to manage public hospitals in line with the Government's programme for reform of the health service. The competencies of the individuals appointed are the key to better management of hospitals and it was on this basis that the interim Board appointments were made. No meeting of the Board has yet taken place. The interim Board will be replaced in due course by a Trust Board on a statutory basis and may be dissolved and reconstituted at any time to facilitate the development of Hospital Trusts.
