Mary Harney (Dublin Mid West, Independent)

I propose to answer Questions Nos. 37 and 47 together. The recruitment of a new chief executive officer is a matter for the board of the HSE, as are the internal governance structures of the organisation. However, I can confirm that certain changes are being introduced in the management structures of the HSE to enable it to better manage and deliver hospital and community services in a more integrated way and to strengthen the role of clinicians in the delivery of services.

In October 2009 the chief executive officer announced that four regional directors of operations were being established. They are accountable and responsible for the delivery of all health and social care services in the existing four geographical areas. In addition, the National Hospitals Office and the primary, community and continuing care directorate were being replaced by an integrated services directorate with two national directors; one responsible for reconfiguration and the other for performance and financial management.

The HSE is also in the process of appointing care leaders – one each for mental health services, disability services, children and family services and services for older people. The appointees will set out operational plans and delivery targets for their areas of responsibility and will be the key link with the Department and external stakeholders.

A new national director of quality and clinical care, Dr. Barry White, has been appointed. His role is to strengthen clinical leadership, improve clinical performance and ensure care is delivered in a way that maximises quality while minimising expenditure. This will involve the development and implementation of care pathways, protocols and standards for different disease programmes, particularly chronic diseases that have a high impact on the health system. In addition, support functions such as ICT, procurement and estates have been amalgamated into a single directorate. The posts which I have mentioned are being filled from within the existing complement of staff.

The aim of the new management arrangements is to deliver excellent health outcomes for the population by driving the integration of hospital and community services, ensure more efficient use of resources, ensure clear lines of management accountability and support its strategy of shifting the balance of activity towards prevention and community-based care and away from hospital-based care.

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