James Reilly (Dublin North, Fine Gael) | Oireachtas source

A key stepping stone towards the introduction of universal health insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of integrated groups. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. To assist the Department in advising the Government on the formation of hospital groups, in June this year I appointed Professor John Higgins to chair a strategic board on the establishment of hospital groups. The strategic board is composed of representatives with national and international expertise in health service delivery, governance and linkages with academic institutions.

A project team was established to make recommendations on the composition of hospital groups, governance arrangements, current management frameworks and linkages to academic institutions for the consideration of the strategic board. The consultation process to inform the project team has been rigorous and comprehensive. It has included meetings with every acute hospital, including consultations on two separate occasions with each hospital in the south-east region. It has involved the receipt of a significant volume of formal submissions from hospitals, clinicians, regulatory bodies and citizens, all of which have been considered.

I have also made clear to the project team and to the board my determination to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. On this basis, the organisation of hospital services nationally, regionally and locally will be informed by the ongoing development of the HSE clinical programmes and by the smaller hospitals framework. This framework defines the role of the smaller hospitals. It outlines the need for smaller hospitals and larger hospitals to operate together and therefore is intrinsically linked to the ongoing work regarding the development of hospital groups.

The work on hospital groups is not about downgrading hospitals. It is about bringing together groups of hospitals into single cohesive entities to allow maximum flexibility in management, budgets and service delivery. It is about ensuring that hospital groups are broadly comparable in size and scope so they can attract high quality staff and trainees across all health care specialties and professions. It is about creating efficiencies by using common business processes and economies of scale and avoiding unnecessary duplication. Most importantly of all, it is about maximising the range of services available to deliver internationally comparable quality care for patients, regardless of where they live.

I hope to receive the report of the strategic board on the establishment of hospital groups later this month and that I will be able to bring this matter to my Cabinet colleagues for decision shortly thereafter. It should be remembered that the hospital groups are an interim collaborative measure pending the legislation required to establish hospital trusts. Before the trusts are established, the composition and functioning of the groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.

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