I propose to take Questions Nos. 1896 to 1899, inclusive, 1901, and 1903 to 1906, inclusive 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, nine Community Healthcare Organisations (CHOs) and six 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 part of this process, my Department undertook a public consultation on the alignment of CHOs and Hospital Groups. The consultation process found that a large majority of respondents are in favour of alignment. The Department of Health also consulted with the European Observatory on Health Systems and Policies to learn from the reorganisation of health services in other countries.
My Department’s detailed analysis work was based primarily on patient flow. This analysis, conducted in partnership with the HSE concluded that the six new regional health areas represent the least change and disruption necessary to achieve optimal alignment of health and social care services at regional level. This means that patients will continue to access services as they currently choose to do around the country.
No external services were procured in determining the new regional areas.
Having determined the optimal configuration for the new health areas nationally, my Department will immediately begin the process of engaging with stakeholders across the system, including the public and health staff, both clinical and managerial. This will be a key pillar of the development of detailed policy proposals on the roles and responsibilities of the new regions (including timelines for the implementation of this reform), which I intend to bring to Government for approval in the next 12 months.