I propose to take Questions Nos. 279 and 280 together.
A clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for 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. As the Deputy will be aware, 9 Community Healthcare Organisations (CHOs) and 6 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 underpinned by population based planning, 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”. As a first step in this process, 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, CHNs and Hospital Groups which can be achieved with minimal disruption, and which will ultimately be the geographical areas of the proposed new regional health bodies. My Department is finalising proposals in this regard, and I hope to bring these proposals to Government shortly, together with the findings of the public consultation, which I expect to be published shortly thereafter.
In parallel, work is progressing in my Department on the development of detailed policy proposals on reconfiguration of the HSE, including the establishment of regional health bodies. This will take into account international experience of regional delivery of healthcare along with a comprehensive engagement process with stakeholders in the Irish health system.