Michael Moynihan (Cork North West, Fianna Fail)
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Question 47: To ask the Minister for Health the relationship and chain of command between his advisors and the Health Service Executive; and if he will make a statement on the matter. [33003/11]

James Reilly (Dublin North, Fine Gael)
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The provisions governing the appointment and role of special advisers are set out in section 11 of the Public Services Management Act 1997. In summary, the role of special advisers is to assist the Minister by providing advice; monitoring, facilitating and securing the achievement of Government objectives that relate to the Department; and performing other such functions as may be directed by the Minister that do not involve the exercise of specific powers conferred on the Minister or other officeholders.

In order to perform their functions, it is important that my special advisers are kept up to date on developments within my Department and the health service generally both by officials in my Department and other agencies, including the HSE. It is also important that information is shared with the special advisers and every effort should be made to keep them briefed on significant issues.

Special advisers are not part of line management in the Civil Service. Accordingly, the briefing of special advisers should be regarded as complementary to the direct briefing of the Minister. It cannot act as an alternative to the direct briefing of the Minister on important areas of policy and operation. While my special advisers have no executive functions, it is reasonable for me to expect that they are kept fully briefed on any issues that relate to my role as Minister in order that they are in a position to provide me with informed advice.

Billy Kelleher (Cork North Central, Fianna Fail)
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I raised this issue previously in another question. There are conflicts between what is being said in the House and what is contained in e-mails from special advisers in the Minister's Department. Without giving names and specifics, e-mails have been sent from the Minister's advisers "with the full authority of the Minister". The advisers either have the full authority of the Minister or they do not. They are circumventing the chain of command and now making recommendations to the HSE with the full authority of the Minister. However, the Minister comes to the House, quotes the Act and claims that they do not have that full authority. Clearly, the Minister's special advisers are acting outside their remit when they can send e-mails to Ms Laverne McGuinness, Mr. Pat Healy and the HSE stating they are acting with the full authority of the Minister.

Tom Hayes (Tipperary South, Fine Gael)
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Does the Deputy have a question for the Minister?

Billy Kelleher (Cork North Central, Fianna Fail)
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Who is in charge of the health service? Who is running it? Do the advisers have the authority to tell the HSE and its managers that they are acting with the full authority of the Minister? Can the Minister give a "Yes" or a "No" answer?

James Reilly (Dublin North, Fine Gael)
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I have already indicated who is in charge of the health service - the Ministers of State and I take that responsibility.

Billy Kelleher (Cork North Central, Fianna Fail)
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Is the Minister taking responsibility now?

James Reilly (Dublin North, Fine Gael)
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Let me finish. The Deputy has asked who runs the health service. Clearly, I do not run it. I take responsibility for it, but it is run by the HSE and there is a chain of command through the Department for policy.

Finian McGrath (Dublin North Central, Independent)
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Last year the Minister was going to sort them out.

Tom Hayes (Tipperary South, Fine Gael)
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Please allow the Minister to answer the question.

James Reilly (Dublin North, Fine Gael)
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With regard to advisers, if I ask my adviser to pass a message or instruction to an individual in the HSE, I see no issue with this. It is the same as me picking up the telephone and saying it myself. There will be specific times when they will be asked specifically to make a request or send a message to an individual. That is entirely different from giving somebody authority across the entire system. The Deputy will find that there have been specific issues, but there is no general ability to instruct or do otherwise.

Billy Kelleher (Cork North Central, Fianna Fail)
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Is the practice still in place whereby advisers, acting on behalf of the Minister, can, with the full authority of the Minister, infer decisions should be made or taken without formal discussions or going through the proper procedures at the HSE, the board and along the chain of command? Do advisers have the authority to put the reconfiguration process on hold, for example, as was stated by one of the Minister's advisers? Clearly, that is not within the remit of the adviser, as the Minister has stated.

James Reilly (Dublin North, Fine Gael)
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I believe the Deputy is alluding to a specific instance in which I had already informed the chief executive officer of the HSE that there should be no further changes without bringing matters to my attention in order that I could study their implications. There might have been times when that message had to be reaffirmed, and this was done through an adviser. I do not see an issue with this. The original instruction came from me and through the Department of Health. In fact, the Secretary General wrote a letter to the HSE advising it of the position. The fact that an adviser might have had to reinforce this subsequently is not a source of grave concern as the Deputy is trying to make out it is.

Billy Kelleher (Cork North Central, Fianna Fail)
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The CEO had that view.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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My point is to focus on whether the aforementioned advisers are advisers to the Minister. I refer to the leaked letter, to which the Minister has just referred, from the Secretary General of the Department of Health to Mr. Cathal Magee, the chief executive officer of the Health Service Executive, HSE. That letter stated it was regular practice to accept "a particular suggestion from an adviser" in place of seeking a formal decision directly from the Minister. Is that the way in which to operate a health service? What does that say to people about who is at the helm of the health service? There is no indication whatsoever that there was any engagement with the Minister. It was the adviser's position, leaving the Minister out of the frame.

Tom Hayes (Tipperary South, Fine Gael)
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Is that the Deputy's question?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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That is precisely what it states and this appears to be most casual.

Tom Hayes (Tipperary South, Fine Gael)
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We are out of time now and we want to get in another question.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Can the Minister assure Members that he is, as he suggested he would be when he took up office, both accountable and responsible for the health services?

Tom Hayes (Tipperary South, Fine Gael)
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The Minister, in a brief response.

James Reilly (Dublin North, Fine Gael)
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I cannot get more brief than "Yes".

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Members will be obliged to judge the Minister on his record.