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.
As a first step in this process, I announced the areas for six new regional bodies last week. This is an important step in signalling the future shape of the health service.
The new structure is not a return to the old health board model. There will be six health regions, whereas there were eleven health boards. Those health boards had political representation; I have indicated that any new boards are likely to be competency-based. While the regions will have devolved responsibility for decision making, they will operate within a national framework, including national policies and strategies, such as the National Trauma Strategy and the National Cancer Strategy and national organisation of certain services such as national clinical programmes, our screening programmes and ambulance services.
As agreed by Government, my Department will now progress the development of detailed policy proposals on reconfiguration of the HSE, including the establishment of regional health bodies, and bring these proposals back to Government for approval next year.
The regions will have a “one budget, one system” approach; improved accountability and governance; equitable resource allocation; and increased clinical governance compliance requirements. They will also be complemented by a lean HSE that will retain responsibility for national services, strategic planning, national systems (e.g. ICT, financial, etc.) and ensuring equity and standards are maintained across regions.