Dan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to this debate on the Health Service Executive (Governance) Bill. I am not surprised that this has been introduced because when I was involved in the debate about setting up the HSE, I expressed my extreme concern about the development of such a monolithic organisation. I appreciate that the objective was to ensure co-ordination between the old health boards and consistency in terms of service delivery. However, this could have been achieved while maintaining and reforming the local health boards themselves.

Admittedly, there were some difficulties with the old health board system but I believe we threw the baby out with the bath water at that time. We now have a situation where there is very little input from service users, interested parties, public representatives and professionals. I was a member of the Mid-Western Health Board for seven years and was also involved in the Association of Health Boards in Ireland and a lot of good work was done by individual boards and by that association. Issues were brought to the attention of Ministers and the Houses of the Oireachtas, in terms of difficulties experienced by people. Such issues were also brought to the attention, at a local level, to the managers of the health boards. Monthly meetings were held, which were attended by public representatives, consultants, dentists, nurses and so on, who would raise, in public and in the presence of the media, their concerns regarding the delivery of health services. The health boards were made aware of the concerns and needs that existed as well as the changes in the requirements of the general public with regard to the delivery of the health services. Furthermore, the Minister was responsible for what was happening in the delivery of health services throughout the country.

The setting up of the HSE changed all of that. The potential for external input all but disappeared and the opportunities for those at the coalface to have an input into the delivery of services were lost. Also, the removal of the responsibility for the delivery of the health services from the Minister created a situation whereby there was a complete lack of accountability to these Houses in terms of service delivery. Others have raised the issue of replies to parliamentary questions about the delivery of health services and the fact that, in certain circumstances, the HSE is quite tardy in issuing responses. It can be extremely frustrating for those of us who want to respond to the concerns of our constituents. In that context, I welcome the fact that the Bill will abolish the structure of the HSE and provide for a directorate to be the governing body of the executive, in place of the board, which will be headed by a director general. The Bill also provides for accountability arrangements for the HSE, which is very important.

I wish to draw attention to the important decision which has been made to appoint a director of mental health services and that the recruitment process is under way. I welcome the fact that the director will have full control of the delivery of mental health services. I also welcome the appointment of Mr. Gerry Raleigh as director of the National Office for Suicide Prevention, which has had a lot of difficulties in the last 12 months, not least the fact that moneys allocated by the Minister to the work of suicide prevention, suicide postvention and research were not spent last year. It is important that the €35 million allocated in the budget for the delivery of mental health services is spent in the most appropriate way to deliver A Vision for Change. There has been much debate about the non-spending of some of the resources last year. However, I understand the complications that arose because of the delay in the formulation of the service plan and the recruitment of the 411 consultants and professional staff for community-based mental health services. I ask the Minister in his response to inform us of the plan for the delivery and improvement of the services, based on this year's allocation of €35 million. We need to know what will happen with that money this year.

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