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

I thank Deputy Ó Caoláin for supporting amendment No. 3. I cannot accept amendment No. 4 because that brings us back to something more akin to a board than to what is intended. The purpose of this legislation is to establish a directorate that is directly involved in, and focused on, service delivery.

I listened to what Deputy Billy Kelleher said and he is right that we are trying to bring in fresh blood across the system. It is important to remember that this is a temporary structure to get us to the health care commissioning agency, which will be advertised publicly. There is no question of smoothing the way for people to get into that organisation using this route. The Deputy is aware of my criticisms of the formation of the HSE and the amalgamation of 11 health boards, when everyone was promised they could not only keep their jobs but keep the same jobs. We got none of the savings or efficiencies that would normally be expected when amalgamating organisations. One expects greater efficiency through a reduction in staff numbers as there is duplication of function across 11 organisations. This is one of the reasons the hospital groups will be effective. They will do away with much of the fragmentation in the health service and duplication in management and administration, with human resources and management across 49 hospitals decreasing to a system that has management across six hospitals. In addition, there will be a new national paediatric hospital group. I hear what is being said but I regret I cannot accept amendment No. 4.

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