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

I regret that the Deputies opposite feel they cannot support the Bill. However, I will address some of the issues raised by them. Regarding the way the directorate will work, it will have collective responsibility as the governing authority for the HSE. In practice, the directorate model will involve a combination of a senior management team working together on major corporate issues but with the usual operational line of reporting to the director general for the specific service functions.

Regarding accountability, the HSE has responsibility for the organisation and delivery of health services and the directorate will be accountable to the Minister for the performance of the HSE functions. It will have to explain its decisions. As chairperson, the director general will account to the Minister on behalf of the directorate in regard to the way the HSE's functions are performed. He or she will do this through the Secretary General of the Department of Health.

The Bill builds on existing accountability provisions in the Health Act of 2004. It allows the Minister to issue directions to the HSE on the implementation of ministerial and Government policies and objectives relating to HSE functions where the Minister believes that the HSE is not having sufficient regard to such objectives or policies in performing its functions. The Minister will also be empowered to specify priorities for the HSE, to which the HSE must have regard in preparing its service plan. The Minister may establish performance targets for the HSE in regard to these priorities. Directions, priorities and targets will not be made in regard to individual patients or service users.

Comments were made about the Secretary General who was appointed in the normal way that all Secretaries General were appointed, namely, through the public appointments system and through competition and, ultimately, I, as Minister, am presented - as are all Ministers - with a choice of three different individuals to appoint.

Deputies spoke about protecting the public purse. Regarding the Department, we have seen our budget cut by €3 billion. We have reduced the number of staff by more than 10,000 in recent years, and there is still not just a safe service but an improved service. That is an improvement that is measurable and reproducible, as in the emergency department figures which show a 24% reduction in the number of people who have to endure long trolley waits at the end of last year-----

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