Dáil debates

Tuesday, 27 April 2010

12:00 pm

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)

Some of the findings of the report in question, which has not yet been published, featured in the media recently, although much of the contextual information and balancing comments did not appear in these articles, and other findings were not commented upon at all. An operational review programme is a management tool to help assess the capacity of Departments and major offices to meet challenges over the coming years. It can be used by Departments to help them improve their performance - in fact, this is the whole idea. The report has been welcomed by the Secretary General and action plans are being prepared in response. We will accept the critiques of aspects of the Department's work and see how they can be improved. Having served in that Department myself, I acknowledge that the staff show much ability and commitment in dealing with a difficult agenda.

The report identifies areas in which improvement is required, and clarifying roles and responsibilities is an important aspect of this. As in every field, it is important to have a clear objective and that management and staff are behind this. The Department is now mainly in the business of policy formation, but when I was there, before the establishment of the HSE, it also had an operational role and was trying to deal with hospital services and every other aspect of the health service on a day-to-day basis through what was then a regionalised health board system.

It must be objectively acknowledged there have been improvements, including the establishment of the National Hospitals Office and so on, and there has been an effort to pull things together to make a far more coherent and joined-up organisation. This may be seen in terms of improvements in operational performance. Of course there are service pressures and organisational problems. When one can find the right people in the right place, one sees a different level of performance in some places compared to others. That is not to say that everyone is starting from the same mark or that people have the same sets of problems but we all know how the degree to which the health service is interactive between primary, secondary and tertiary care. We need good local organisational efforts as well as a centralised approach that brings clarity to the policies and enables people to get on with the job as effectively as possible.

Mention was made of managing delivery by agencies through stronger goals and output and performance measurement, as was more clearly defining customers and stakeholders and a closer alignment to serving them more appropriately. It is not a question of the Department being unaware that it exists to serve the public; it is a matter of ensuring that the many agencies and organisations which are delivering health services have a proper relationship that maximises effectiveness and allows people to work as efficiently as possible.

I do not think any review worth its salt would be able to give a clean bill of health to every organisation. If it did, it might suffer from the criticism that it was not a very rigorous or robust exercise. The review is seen as a management tool or a SWAT analysis which evaluates how services are being delivered, the extent to which the Department is fulfilling its role, its place in the delivery of services and, in this case, how one organises the services and how agencies meet their remits and responsibilities. That is the purpose of an operational review programme. Everyone in this House would rightly point to the need for periodic objective and robust exercises to assess how people are performing.

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