Máire Hoctor (Tipperary North, Fianna Fail)

I move: "That the Bill be now read a Second Time."

The Health (Miscellaneous Provisions) Bill 2009 has several purposes. First, it gives effect to the Government's policy on the establishment of the office for older people within the Department of Health and Children, and it develops the integration of other health service agencies in line with the objectives of the health service reform programme and the Government's policy on agency rationalisation. Second, it provides for ministerial responsibility for the local government superannuation scheme for the health sector to transfer from the Minister for the Environment, Heritage and Local Government to the Minister for Health and Children. It also gives legal effect to amendments made to this scheme by the Minister. The third element of the Bill is the amendment of the Hepatitis C Compensation Tribunal Act 1997, as amended, to remove age limits for the travel insurance benefit provided in accordance with that Act. Fourth, the Bill makes certain technical amendments to the Health Act 2007. Finally, the Bill amends article 5 of the National Cancer Registry Board (Establishment) Order 1991, which deals with the composition of that board. This is in fact linked to policy on agency integration in the health service. I propose to give an overview of the different policy areas of the Bill and then to set out the provisions of the Bill in more detail.

One of the objectives of the health service reform programme was the rationalisation of health sector agencies, as recommended in the 2003 prospectus report on the audit of structure and functions in the health system. Successive Governments had established a range of health agencies, with over 55 such agencies established by 2003. These individual agencies each played a valuable role in the development of our health services. However, the multiplicity of agencies led to an overly complex and fragmented system that was ultimately unsustainable. Steps were therefore taken to rectify this situation with the integration of a number of agencies within the Health Service Executive and other bodies.

In light of the efficiency review announced in 2007 and the publication of the OECD review of the Irish public service, the Government agreed a process of rationalisation of State agencies. There are certain principles underpinning and guiding these policies of rationalisation. One principle is that the function of assisting Ministers in the formulation of policy is usually best located in Departments and should not be devolved unnecessarily to outside agencies. A further principle is that streamlining roles and operations should be maximised by eliminating the duplication and the overlap of functions between agencies, and by amalgamating bodies with similar roles. The Bill develops this programme of streamlining by paving the way for the integration of the National Council on Ageing and Older People and the Women's Health Council with the Department of Health and Children, and for the integration of the National Cancer Screening Service Board, the Drug Treatment Centre Board and the Crisis Pregnancy Agency with the Health Service Executive.

The Minister is very conscious that these are agencies which enjoy great respect. The National Council on Ageing and Older People has made a significant contribution to policy development regarding older people. The Women's Health Council has played a major role since its establishment. The National Cancer Screening Service Board has played a pivotal role in the provision of cancer prevention services to women through the BreastCheck and CervicalCheck programmes. The Drug Treatment Centre Board has made a highly valued contribution to the delivery of treatment services for drug misusers. The work of the Crisis Pregnancy Agency has been crucial in the implementation of strategies to reduce the number of crisis pregnancies.

We are at a point, however, where we need to bring together these agencies with others to achieve all the benefits that are gained from co-ordination, consolidation and integration. While there is a clear need to secure efficiencies from the rationalisation programme, the primary aim is to streamline service delivery and policy making in these areas. Efficiencies will be gained over time from economies of scale and the elimination of duplication in areas such as recruitment procurement, payroll and ICT systems. While change can be challenging, the Minister believes that the integration of policy formulation and services is the best way forward.

In the case of the National Council on Ageing and Older People,the Government approved the creation of an office for older people on 23 January 2008 to support me as Minister of State with responsibility for older people within the Department of Health and Children, the Department of Social and Family Affairs and the Department of Environment, Heritage and Local Government. As part of the creation of the office, the Government decided to subsume the existing staff of the national council into the Department of Health and Children. The staff of the national council have built up a range of expertise and experience on older people's issues that they can bring to the work of the office for older people, and in particular to the development of the national positive ageing strategy. It is the intention to establish a national advisory council on older people on an administrative basis.

The Women's Health Council advises the Minister for Health and Children on women's health and on the implementation of recommendations on women's health contained in policy reports commissioned by her. The integration of the role of the council within the Department of Health and Children was recommended in the 2003 report on the audit of structure and functions in the health system. This integration was also part of the rationalisation of State agencies announced last October.

Cancer screening is an intrinsic component of the national cancer control programme and the integration of screening services within the programme is the best way to ensure the full co-ordination of services and resources in the fight against cancer. The Drug Treatment Centre has been funded directly by the HSE for some time. The integration of the Crisis Pregnancy Agency within the HSE will facilitate co-ordinated planning in the area of crisis pregnancy as part of the HSE's overall planning for and provision of health and social services, including contraception and sexual health strategies, family support, support for immigrant communities and teen parent support programmes. The integration of the functions and staff of all the bodies will be carefully managed to ensure a seamless continuation of the important services they provide.

The Minister does not in any way underestimate the complexities of the health service rationalisation programme. I said earlier that change is challenging, but it is not impossible. Considerable effort has been already invested in preparing for integration and this effort will continue to ensure that the integration process works smoothly. In the particular case of the National Council on Ageing and Older People, the transition process is facilitated by the fact that the staff of the Council have been located in Hawkins House since February 2008, and that a principal officer of the Department is director of the council for the transition period.

Part 7 of the Bill, which contains section 60, confers the same powers on the Minister for Health and Children as those conferred on the Minister for the Environment, Heritage and Local Government under sections 2 and 4 of the Local Government (Superannuation) Act 1980 in respect of a range of health sector organisations. All powers exercised by the Minister for Health and Children under sections 2 and 4 of the Local Government (Superannuation) Act 1980 since 1 February, 2001 are confirmed and they apply to all of the organisations mentioned in section 60.

The Bill also makes some miscellaneous amendments to other legislation. The Hepatitis C Compensation Tribunal (Amendment) Act 2006 provides the legislative basis for setting up an insurance scheme for persons infected with hepatitis C and HIV through the administration within the State of infected blood or blood products. This provision is intended to assist these people with hepatitis C or HIV to obtain insurance where they would otherwise have difficulty in doing so on the open market. The upper age limit of 65 for the scheme is contained in the Act. The Minister agreed last July to remove the age restriction on the travel insurance element of the scheme, on the basis that it discriminates against older age groups who wish to travel.

The Health Act 2007 provided for the establishment of the Health Information and Quality Authority, the office of the chief inspector of social services and a new inspection and registration system for designated centres — that is, residential centres -for older people, children and people with disabilities. Amendments to the Act under the current Bill correct minor typographical errors, and also enhance provisions for the making of regulations requiring registered providers of designated centres to make arrangements for dealing with complaints under section 103(3) of the Act.

The Government's rationalisation programme for agencies includes the integration of the National Cancer Registry within the HSE. As a first step in this process, the establishment order for the National Cancer Registry Board is being amended to change its provisions for board composition. These currently provide for the Minister to appoint a board of up to ten persons nominated by various bodies, an arrangement which has served the health service well. However, as part of the preparation for integration within the HSE, it is important at this stage to facilitate the forging of closer links between the registry and the national cancer control programme of the HSE. Therefore, the Bill amends the provisions of the establishment order for the registry to allow the appointment of a seven person board with knowledge or experience of the functions of the board, including those related to Government policy on cancer control.

I refer to the principal features of the Bill. Part 1, comprised of sections 1 to 3, inclusive, contains standard provisions dealing with the short title, commencement, definitions and expenses. The legislation will come into operation by ministerial order and different provisions will be brought into operation at different times.

I refer to the National Council on Ageing and Older People. Part 2, comprised of sections 4 to 14, inclusive, provides for the dissolution of the National Council on Ageing and Older People. Section 5 dissolves the council. Section 6 transfers rights and liabilities of the council to the Minister for Health and Children. Section 7 transfers land, other property and any moneys, stocks and shares and securities of the council to the Minister. Section 8 requires the Minister to cause final accounts of the council to be prepared and to submit them to the Comptroller and Auditor General for audit. Copies of the audited accounts and the Comptroller and Auditor General's report on the accounts must be laid before each House of the Oireachtas. Section 9 requires the Minister to cause a final report of the council's activities to be prepared and to lay copies of the report before each House of the Oireachtas. Section 10 substitutes the name of the Minister for Health and Children for the name of the council in any pending legal proceedings to which the council is a party immediately before the commencement of Part 2. The proceedings shall not abate by reason of such substitution. Section 11 provides that every contract or agreement made between the council or any trustee or agent thereof acting on its behalf, or any other person, which is in force immediately before the commencement of Part 2 shall continue in force and shall be construed and have effect as if the Minister were substituted therein for the council and shall be enforceable against the Minister.

Section 12 provides that every person who, immediately before the commencement of Part 2, is an employee of the council shall, on the commencement of Part 2, hold an unestablished position in the Civil Service. Save in accordance with a collective agreement negotiated with any recognised trade union or staff association concerned, a person transferred shall not, on the commencement of Part 2, be brought to less beneficial conditions of remuneration than the conditions of remuneration to which he or she was subject immediately before the commencement of Part 2. The previous service of a person transferred shall be reckonable for the purposes of the employment legislation set out in subsection (3) of section 12, subject to any exceptions or exclusions in any legislation. Any superannuation benefits awarded to, or in respect of, a person transferred and the terms relating to those benefits shall be no less favourable than those applicable to, or in respect of, that person immediately before the commencement of Part 2. The pension payments and other superannuation liabilities of the Council in respect of its former employees become, on the commencement of Part 2, the liabilities of the Minister for Finance. A person transferred under section 12 shall undertake such duties as the Minister may, from time to time, direct and shall be subject to and employed in accordance with the Civil Service Regulation Acts 1956 to 2005.

Section 13 transfers each record held by the council immediately before the commencement of Part 2 to the Minister. Section 14 revokes the establishment order for the National Council on Ageing and Older People.

Part 3 comprised of sections 15 to 25, inclusive, provides for the dissolution of the Women's Health Council. The provisions of Part 3 are similar to those in Part 2 in regard to the National Council on Ageing and Older People.

Part 4 comprised of sections 26 to 36, inclusive, provides for the dissolution of the National Cancer Screening Service Board. Section 28 transfers rights and liabilities of the board to the Health Service Executive. Section 29 transfers land, other property and any moneys, stocks and shares and securities of the board to the Health Service Executive.

Section 30 requires the Health Service Executive to cause final accounts of the board to be prepared and to submit them to the Comptroller and Auditor General for audit. A copy of the audited accounts and the Comptroller and Auditor General's report on the accounts shall be submitted to the Minister who shall lay copies of the audited accounts and the Comptroller and Auditor General's report on the accounts before each House of the Oireachtas. Section 31 requires the Health Service Executive to cause a final report to the Minister of the board's activities to be prepared. The Minister shall lay copies of the final report before each House of the Oireachtas. Section 32 substitutes the name of the Health Service Executive for the name of the board in any pending legal proceedings to which the board is a party immediately before the commencement of Part 4. The proceedings shall not abate by reason of each substitution.

Section 33 provides that every contract or agreement made between the board or any trustee or agent thereof acting on its behalf, or any other person, which is in force immediately before the commencement of Part 4 shall continue in force and shall be construed and have effect as if the Health Service Executive were substituted therein for the board and shall be enforceable against the Minister.

Section 34 provides that every person who, immediately before the commencement of Part 4, is an employee of the board shall, on the commencement of Part 4, be transferred to and become an employee of the Health Service Executive. Save in accordance with a collective agreement negotiated with any recognised trade union or staff association concerned, a person transferred shall not, on the commencement of Part 4, be brought to less beneficial conditions of service, including conditions related to tenure, or of remuneration to which he or she was subject immediately before the commencement of Part 4. The previous service of a person transferred shall be reckonable for the purposes of the employment legislation set out in subsection (3) of section 34, subject to any exceptions or exclusions in that legislation. Any superannuation benefits awarded to or in respect of a person transferred and the terms relating to those benefits shall be no less favourable than those applicable to or in respect of that person immediately before the commencement of Part 4. The pension payments and other superannuation liabilities of the board in respect of its former employees become, on the commencement of Part 4, the liabilities of the Health Service Executive. A person transferred under section 34 shall be subject to and employed in accordance with the Health Acts 1947 to 2008.

Section 35 transfers each record held by the board immediately before the commencement of Part 4 to the Health Service Executive. Section 36 revokes the National Cancer Screening Service Board (Establishment) Order 2006.

Part 5, comprised of sections 27 to 47, inclusive, provides for the dissolution of the Drug Treatment Centre Board and the provisions are similar to those in Part 4 for the dissolution of the Cancer Screening Service Board.

Part 6, comprised of sections 48 to 59, inclusive, provides for the dissolution of the Crisis Pregnancy Agency. The provisions are similar to those in Parts 4 and 5. In addition, there is provision under section 50 for the transfer of functions from the Crisis Pregnancy Agency to the HSE in view of legal advice that the executive does not currently have the statutory authority to carry out these functions.

The functions transferred under the Bill are: preparation of a strategy to address the issue of crisis pregnancy in consultation with specified Departments and other appropriate persons; to work with appropriate agencies to promote and co-ordinate the attainment of the objectives contained in the strategy; to produce periodic reports on progress and to propose remedial action where required; to further the attainment of the objectives of the strategy by promoting public awareness, developing, promoting and disseminating information and informational material and by fostering the provision of education and training; to draw up codes of best practice for consideration by agencies and individuals involved in providing services to women with crisis pregnancies; to furnish advice to the Minister for Health and Children and to other Ministers on issues relating to crisis pregnancy; and to perform any other function in respect of crisis pregnancy that the Minister may assign.

I refer to superannuation. Part 7 comprises section 60 of the Bill and confers the same powers on the Minister for Health and Children, from 1 February 2001, as were conferred on the Minister for the Environment, Heritage and Local Government under sections 2 and 4 of the Local Government (Superannuation) Act 1980 in respect of the organisations set out in that section.

I refer to miscellaneous amendments including those relating to hepatitis C. Part 8, comprised of sections 61 to 63, inclusive, provides for miscellaneous amendments to other legislation. Section 61 provides for the amendment of the Hepatitis C Compensation Tribunal Act 1997 to remove the age limits in respect of the travel element of the insurance scheme established for persons infected with hepatitis C or HIV through the administration within the State of infected blood or blood products.

Section 62 makes technical drafting amendments to the Health Act 2007, including that regulations for arrangements by registered providers of designated centres under that Act may encompass arrangements for dealing with complaints made on or on behalf of persons who are no longer receiving a service at the centre.

Section 63 amends article 5 of the National Cancer Registry Board (Establishment) Order 1991 to provide for the appointment by the Minister of a seven person board with knowledge or experience or relating to particular functions and other relevant competencies to assist the board in the performance of its functions.

On behalf of the Minister for Health and Children, I acknowledge the contribution to the health service made by the National Council on Ageing and Older People, the Women's Health Council, the National Cancer Screening Service, the Drug Treatment Centre and the Crisis Pregnancy Agency throughout the years.

The Minister acknowledges the commitment of these agencies over the years. They have performed a significant public service for which we thank them. The policy areas and services will not be diminished by the integration of these bodies with the Department of Health and Children or the HSE but will, on the contrary, continue in their new environments. I commend the Bill to the House.

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