Tony Killeen (Clare, Fianna Fail)

I propose to take Questions Nos. 54 and 88 together.

The PA report assessed the current arrangements for the provision of medical services and proposed a model for future delivery of those services. The consultants recommended a programme of major change. The high level recommendations include a centralised command structure for the Medical Corps and the creation of a medical services management and administrative function. This structure will provide strategic planning, resource allocation and overall responsibility for the management and delivery of the medical service and for the development of medical officer-led care teams, together with a refocusing of medical staff on appropriate clinical tasks. The structure and systems recommended have been designed to meet the demands and needs of the modern Defence Forces at home and overseas and provide medical officers with a fulfilling and rewarding career. The implementation schedule follows the recommendations made by PA. Many of the recommendations made in the PA report are of a high level strategic nature.

The governance structure proposed in the report for the delivery of change in this area has been put in place. A dedicated programme group with civilian and military representatives is co-ordinating a range of projects. Progress has been made on implementation of the PA recommendations including, alignment of Defence Forces and medical corps strategies, redesign of the medical care model in the Defence Forces, a centralised command structure, informed service provision through strategic and operational demand and capacity planning and the making available of accurate and timely health and business information available. Also included are a performance-based approach to managing demand and ensuring efficient use of resources and support to sustaining and developing the medical service within the PDF.

As recommended, working groups have been set up to progress the various projects identified. These continue to meet regularly and all have submitted reports. The steering group has considered all of these reports. While none of the seven recommendations from the PA report has been completely implemented, the programme of implementation is progressing. In particular, the steering group has approved the high level organisation for the unit, which now includes a line officer at the rank of colonel commanding the medical corps. It has also authorised the immediate introduction of an annual medical for all Defence Forces personnel and directed, following the findings and recommendations of the future medical information system working group, that all medical corps personnel will use the personnel management system medical module. Formal links have been established with the Medical Council, the Health Services Executive, the Royal College of Surgeons in Ireland and other relevant bodies to explore external training for doctors in the Defence Forces medical services.

Final reports from a number of the working groups including those on the future medical information system, organisation and establishment, training and education, and financial arrangements and outsourcing are due to be delivered by 30 April 2010. The clinical review working group is not due to submit its final report until 30 September this year with monthly reports to be submitted in the interim. It is only following completion of this phase that full implementation of the recommendations can be achieved.

It is expected there will be substantial progress before the end of the year in implementing recommendations. Some issues will be resolved quickly while others will require significant consideration and will, for example, require negotiation with the representative associations.

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