Billy Kelleher (Cork North Central, Fianna Fail)

The fundamental issue is who is in charge of the health services. E-mails sent from Cathal Magee, the CEO of the HSE, to Michael Scanlan, the Secretary General of the Department of Health, state there is confusion and uncertainty about the governance of the system with regard to whether it is the Minister's advisers, the HSE, the Department of Health or the Minister who is in charge. There has been a substantial drift in dealing with the budgetary issues we now face. Decisions have not been made in recent months, other than on the PR exercises such as the special delivery units and the sacking of the board.

The substance of the issue is the clear problem with governance of the Health Service Executive because it does not know who are its masters. Is it the Minister's advisers, the Minister, the Secretary General or the board? Some of the e-mails being sent to and fro are quite disturbing because they deal with the very heart of the provision and delivery of health services. If there are to be changes in governance in the meantime, hospitals, hospital managers and HSE staff are unsure as to who is running the health services.

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