The report of the cross-party Oireachtas Committee on the Future of Healthcare, Sláintecare, identifies four core building blocks that underpin a well-functioning health system. The first of these building blocks is a clear governance and accountability framework. As part of its recommendations in this area, the Committee called for the establishment of a HSE Board, the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.
The report further recommends that these new regional bodies should be established through the geographic alignment of current administrative regional structures. As the Deputy will be aware, 9 Community Healthcare Organisations (CHOs) and 7 Hospital Groups are in place on an administrative basis to plan and deliver community and acute care services respectively. While significant progress has been made by these structures, there is broad consensus that having separate and un-aligned structures for acute and community care impedes the development of a more integrated health service as envisaged under the Sláintecare programme.
In this regard, the Sláintecare report recommended that “further analysis and consultation should be undertaken to identify how alignment can best be achieved with minimal disruption to key structures including at community healthcare network level”.
The Government’s Sláintecare Implementation Strategy published in August 2018 and the 2019 Sláintecare Action Plan published in March 2019 commit to the development of a new system of health structures and governance as called for in the Sláintecare report. The Strategy and the Action Plan set out a number of actions to deliver on this commitment. This includes determining the optimal approach for aligning current CHO and Hospital Group structures to provide the geographical basis for the proposed new regional bodies.
As a first step, my Department undertook a public consultation regarding the geographical alignment of CHOs and Hospital Groups in 2018. In addition, my Department has carried out further detailed analysis work to determine the optimal geographical alignment of CHOs and Hospital Groups which can be achieved with minimal disruption, and which will ultimately be the geographical areas of the proposed new regional integrated care organisations. My Department is finalising proposals in this regard, and I hope to bring these proposals to Government shortly.