Regina Doherty (Meath East, Fine Gael) | Oireachtas source

I would hate to see how Deputy Jerry Buttimer would react if he was really upset by our colleagues across the floor.

I welcome the opportunity to contribute to the debate on the Bill. It is no secret that the Government inherited a health care system in crisis. The health care system is engaged in an ongoing process of change and transformation at every level. The key focus is to ensure all our resources are directed towards better services for the population. This programme of transformation of health services calls for a change in not only what we do, but also in how we do things and work together to deliver integrated patient-centred services. As we continue to make progress, guiding and leading change across the entire system is a key challenge for everyone in the health service. The Government is committed to meeting this challenge and continually seeking ways to improve the way things are done.

The magnitude of what lies ahead requires a robust infrastructure for deliberation and decision-making. Establishing that infrastructure is the purpose of the legislation before the House.

The new structures within the Health Service Executive (Governance) Bill 2012 will allow us to redesign the system to place the needs of the patient at the front and the centre. In order to achieve a new degree of transparency, accountability and efficiency prior to its abolition, the HSE will be reorganised along service lines. The new directorate structure involves the identification of clear areas of priority and the establishment of responsible directors for these service lines. This programme of reform replaces the HSE with six new directorates to be overseen by a director general. It will also allow the reorganisation of services to prepare the way for the wider introduction of the money follows the patient principle and the ultimate introduction of universal health insurance.

The purpose of the new directorate team will be twofold. It will run the health services as they operate and prepare for the transformation required in the move to universal health insurance. The clear identification of the seven directorates or service lines will provide considerable clarity in the delivery of the relevant services under the responsibility of the directors and for greater financial transparency and accountability in assessing these services. It is proposed that the persons who will take up the directorates will be a combination of existing HSE directors and persons to be identified by internal competition. The new directorate system will give us clear sight of budgets and where the money is being spent. The Minister for Health, Deputy James Reilly stated, "For too long the treatment of patients in health services has had to conform to the needs of the system, whereas this new directorate structure in the HSE will allow us to redesign the system to put the needs of the patient at the front and centre." The patient is the key stakeholder.

Change has become an ever-present feature of our work environment and the management of the continuing changes is a key challenge for all managers in service delivery. The policy of administrative control within the health service has changed little in the past decade, despite the advent of a national strategy, planning legislation and structural reform. The Bill alters all of this, with the key to the change being governance. Governance needs to be at the heart of health sector reform. It is vitally important that as we move towards new operating models, there is due diligence in the way we make the transition in order that patient safety is maintained. Governance is an essential element for success in improving quality and safety performance, reducing costs or collaborating with the medical profession to participate in new forms of care provision. Governance requires a unique set of policies which must be supported by structures and mechanisms that facilitate collaboration. The engagement of people is a defining factor.

Together with governance, accountability has become a major issue in the health care system. The Bill will bring about a health care system which will be accountable on roll-out, delivery and maintenance. It will build internal capacity to conduct organisational assessments, communicate effectively, motivate and lead change and create an open environment that will allow people to reflect on and learn from their mistakes and failures. These initiatives add value for the community and other stakeholders. From now on there will be clear and unambiguous section by section delivery, with transparent outputs and outcomes. We have learned a lot of lessons from our predecessors on how to do things in the wrong way; we are going to learn how to do it in the right manner.

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