Róisín Shortall (Dublin North West, Independent) | Oireachtas source

I have serious concerns about the impact of this legislation. It has been presented to us under the guise of reform when, in fact, it is a fig leaf to deal with a corporate governance mess created by the Minister for Health. It shows scant regard for the elements required for corporate governance in the health service, the premier public body, with a staff of nearly 100,000 and a budget of €13 billion. It is incredible that the Minister is moving to remove checks and balances which have applied in the past in this organisation.

It is very easy to denigrate the HSE. Goodness knows, we are all too well aware of the flaws in its establishment. However, it is much more challenging to reform an organisation. It is easy to say we will abolish it, staking a claim to the swashbuckling approach to health reform never having thought about what will replace it. It may be slow going, dull and boring, but at this stage in the country’s development people have come to realise the importance of good standards in corporate governance, as well as the importance of having checks and balances to ensure transparency and accountability in public organisations. I am concerned that this message does not seem to have got through to the Administration.

The standard practice in a public body is that an independent board operates at arm's length, provides oversight and accountability for the spending of public money and is accountable to the taxpayer for the spending of that money. However, unfortunately, in 2011 one of the early steps the Minister took, to make some kind of name for himself, was to abolish the board of the HSE, a board which was made up of very well respected public people, in the guise of doing something about the problems in the health service. As a result of that, a legal difficulty was created and this "makey-up" board was put together to tide the Minister over as a vacuum was created in the governance of the health service. Rather than now admitting that was a mistake and putting in a proper independent board, a convoluted structure is being proposed under this legislation to create a directorate where there will be no division between senior management and what is supposed to be the oversight body, which is the directorate. In corporate governance terms, that must raise very serious questions and concerns. I am surprised this legislation has got to the point it is at given the lack of proper procedure and given the fact that a type of circular arrangement is proposed under the legislation where the director general outside of the boardroom will be in charge of the other directors but when they go into the boardroom that position will be reversed and the director general will be answerable to his senior management team because they are directors in effect.

This is an extraordinary model for corporate governance. It is hugely problematic and does not provide the independent oversight that is required. This kind of lazy and unacceptable approach runs through the Bill. It also comes to the fore with the appointment of the first director general where there is no requirement to have a public open competition. The Minister will decide who will get that job, just as he decided who was going to be brought into the Department of Health to head it up both in terms of the Secretary General and the new layer he created with the special delivery unit. People were again brought in without there being a public competition and under very unusual remuneration arrangements where two people were paid through a UK company. It is quite extraordinary and incredible that a Minister with little political experience can get away with this kind of thing. I believe that we will pay a price for that in the future.

It is also quite indicative of certain disregard for proper corporate governance that when I raised the issue of the possibility of a person who has been adjudicated to be bankrupt continuing as a director or director general of the HSE and said that it would be wrong for a person with those kinds of pressures to continue in that job, the Minister said that it would not help the pressure if they lost their job. That is not the point, rather the point is that a person in that situation is required to be accountable for the spending of large amounts of public money and there is a legal and moral responsibility on Ministers to protect the public purse and ensure proper procedures are in place.

I continue to have serious concerns about this measure and the fact that far too much power is vested in one person, namely, the Minister and that there are none of the normal checks and balances required under modern day corporate governance standards. It seems incredible that this convoluted structure is being put in place for a very short period, as it has been stated that the HSE will be abolished completely by 2014. I challenge anybody on the Government side of the House to tell us what will replace the HSE. Who will deliver the services? I repeat my concern that this is part of a plan to dismantle the public health service and that we will end up in a situation, as the Minister has stated in replies to parliamentary questions, where insurance companies will be the principal purchasers of health care in hospitals and in primary care. It is not in anybody's interest that we have a health service that is determined and effectively run by insurance companies that become the principal purchasers of care at primary and hospital care level. That is the reason I have serious concerns about where the Minister is headed in regard to our public health service, and this legislation adds to those concerns. I am completely opposed to it.

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