Simon Harris (Wicklow, Fine Gael) | Oireachtas source

There are two parts to the Deputy's question, the first of which concerns the governance structures in place in the health service in general which the Sláintecare committee decided unanimously were inadequate. That is a view I expressed when I came to the committee and why I have worked hard to put a board in place. One could argue that the HSE has had a board before now. That is factually correct, but it was a different type of board in terms of skill sets. I do not mean that in a disparaging way towards former boards, but having the right skill sets is essential. The committee has a view that I have not got the skill sets fully right and wants me to put clinicians on the board. We are working our way through to have a robust, competence based board which I expect to take office at the start of June. We have to get the governance structures correct, but we also, through the accountability structures, have to ensure that when the money leaves the Department of Health or the HSE, it is spent appropriately locally. One cannot have a situation where one hospital group works really hard to try to come in on budget and another that blows its budget and the hospital that is performing well is expected to compensate. One must reward good behaviour. The regional board structure will provide for a greater layer of oversight in order that every question will not have to be referred to the Minister of the day or the Oireachtas. There is a need for greater scrutiny. I know that the Deputy is a strong advocate of the health board structure. I suggest the new model we are proposing under Sláintecare offers the best of both worlds, such that one would have a strong slimmed down national centre, with more functions devolved to the regions, with better regional oversight, in order that, as the Deputy said, one would not hear in September that the HSE had overshot its budget by X hundred million euro, that there were early warning signs and about the ways to work through the budget both at individual hospital level and national level.