Dáil debates

Thursday, 30 April 2009

Health (Miscellaneous Provisions) Bill 2009: Second Stage (Resumed)

 

2:00 pm

Photo of Barry AndrewsBarry Andrews (Dún Laoghaire, Fianna Fail)

As I was saying, the Centre for Early Childhood Development and Education is to be subsumed into my office, but this will not require any statutory change. The OECD mentioned in particular the Office of the Minister for Children and Youth Affairs for the way in which it interacts with the main Government Departments and other agencies. This step is in keeping with the announcement in the budget that we will be rolling out an free early-years preschool system for all three and four year olds. The centre will bring to the Department a level of expertise that has hitherto been farmed out to other agencies, which is welcome. It has been suggested the Government is afraid to make tough decisions, but we have been making extremely tough decisions, and this has been recognised internationally. The Deputies do not have to take our word for it. Many commentators have noted that the tough measures in the emergency budget and last October's budget attracted much praise for the mettle shown by the Minister for Finance.

The health reform programme acknowledged that there was a need to streamline the number of health sector agencies with a view to achieving a more co-ordinated system. This objective was echoed in the Government's plans, announced last year, for the rationalisation of State agencies. The primary aim in rationalising these bodies is to streamline service delivery in the health service and promote service integration. The proposals are consistent with and build upon progress to date with agency rationalisation in the sector under the overall health reform programme. However, the Minister expects financial efficiencies to be gained over time due to economies of scale and the elimination of duplication in areas such as recruitment, procurement, payroll and ICT systems.

Deputies have raised concerns that the impact of the Women's Health Council and the National Council on Ageing and Older People will be diminished when they are integrated into the Department. The primary function of these two agencies is to give advice to the Minister. The repositioning of this advisory function with regard to women's health and older people in the Department will facilitate the Minister in formulating policy in these areas. It has often been a criticism that Departments do not have the expertise to formulate policy, and these steps will serve to address that perceived shortfall. Employees will be transferred under the Bill and their expertise, therefore, will be retained as they become civil servants in the Department.

Employees of the Crisis Pregnancy Agency, the Drug Treatment Centre Board and the National Cancer Screening Service Board will be transferred to the HSE and thus their skills will remain within the public health service. In the case of the Crisis Pregnancy Agency, the Bill expressly provides for the transfer of functions to the HSE in line with legal advice. The work of these bodies will be continued within the HSE and the integration of their functions and staff will be carefully managed to ensure the seamless continuation of services.

The National Cancer Registry will be integrated within the HSE in due course and the amendment to the board's structures is, as was outlined by the Minister, intended to forge closer links between the registry and the HSE's national cancer control programme. The board is currently composed of up to ten persons appointed by the Minister, seven of whom are appointed on the nomination of particular bodies such as the Irish Cancer Society and the Royal College of Surgeons in Ireland. The Bill provides for the appointment of a seven-person board with knowledge or experience of the collection, recording and analysis of information, the use of such information in research projects, or the management and planning of services.

Deputies have asked how they might ensure services are not impaired on the integration of the five agencies within the Department of Health and Children and the HSE. There are well-established accountability arrangements in place. The Minister is accountable to the Oireachtas and the chief executive of the HSE is required to appear before Oireachtas committees. Both the Department and the Health Service Executive publish annual reports which set out activities and service developments and which are, appropriately, subjected to the not inconsiderable glare of the media.

I thank Deputies for their contributions. The Minister looks forward to further constructive examination of the Bill on Committee Stage.

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