Michael Finneran (Roscommon-South Leitrim, Fianna Fail)

I thank the Deputy for raising this issue and I welcome the opportunity on behalf of my colleague, the Minister for Health and Children, to reaffirm the Government's commitment to the principles underpinning the establishment of the Health Service Executive as a single, national authority with responsibility for the management and delivery of health and personal social services. While I understand the Deputy's concern in respect of some of the issues raised by him, this should not detract from the significant progress that the HSE has achieved on several fronts in the reform of our health and social care services since its establishment five years ago.

The strategic reasons for abolishing the health boards and certain other agencies and replacing them with a single national authority remain as valid as ever. Reform of our health system was driven by the need to bring about improvements in services to patients and other users through the organisation and delivery of consistent national services, based on objective standards and implemented in a uniform manner throughout the country which made the most beneficial, effective and efficient use of taxpayers' money.

The vital work that is now well under way to implement a national cancer control strategy was made possible by the unified HSE structure. Similarly, the implementation of national standards for nursing homes throughout the country has also been greatly facilitated by a single structure, as has the introduction of the Fair Deal nursing home scheme. Likewise, the implementation of critical primary care and chronic illness strategies also require a single, national management structure. Over time, these strategies will deliver real and tangible benefits that would not have been possible to achieve under the previously fragmented system.

The HSE has recognised that its own internal structures must be reorganised to improve the delivery of health and personal social services on an integrated basis and to improve accountability at all levels of the organisation. That is why it has moved to put in place an administrative regional structure, within the national structure, to drive operational performance and accountability on the ground.

The sheer scale and complexity of the health service reform programme cannot be underestimated. It is the biggest reform project ever undertaken in the country and change of this magnitude can only be successfully achieved over a timeframe of several years. It is inevitable that deficiencies will come to light as the reform programme evolves and it is imperative that the HSE takes the necessary corrective action to address these as they arise.

However, as I stated earlier, the policy objectives behind the establishment of the HSE are as valid today as they were seven years ago when the Government took the strategic decision to establish a single national authority to replace the seven regional health boards, the Eastern Regional Health Authority, the three area health boards and several other agencies. Improving the range and quality of services to patients, clients and other users of our health and personal social services is at the heart of the reform programme and the Minister for Health and Children remains steadfast in her view that this can best be achieved through a unified national structure as the progressive implementation of the national cancer control programme has clearly demonstrated.

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