Mary Harney (Dublin Mid West, Progressive Democrats)

I have had a number of discussions with the chairman and the chief executive officer of the Health Service Executive about a targeted voluntary early redundancy scheme to be introduced for the HSE. Initially, the scheme will concentrate on surplus management and administrative staff. This will be extended to other staff in due course. It will apply to staff at corporate HSE and also to staff at hospital and community level. This decision was reaffirmed by the Minister for Finance in his budget speech on 14 October.

The HSE announced plans in July to modify its structures, including merging the existing hospital and community pillars at national and regional level. The purpose of this is to have clear lines of authority and accountability for delivering services to patients from national to local level, and between hospital and community services. Initiatives that lead to improved efficiencies and the reduction of administrative duplication at all levels of the HSE will be part of the scheme.

One such example is a plan to create single unified organisation structures between a number of hospitals. The aim of this model is to ensure that health service delivery is planned and organised on the basis of a single entity, thus optimising the use of resources, streamlining decision-making, harvesting the benefits of critical mass and avoiding wasteful duplication. Where two hospitals are to operate as a unified entity, there is no need for a duplication of payroll, personnel, IT offices and many other backroom services. This will lead to efficiencies of between 10% to 20% in administration costs.

Similar initiatives at community level will lead to equivalent efficiencies. As we continue to bring together services through primary care teams, there is an opportunity to reduce levels of administration and to facilitate more clinician-to-clinician engagement regarding the care of patients. I support the rationale for this model of shared services, which is very much in line with the health reform programme.

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