Seán Kenny (Dublin North East, Labour) | Oireachtas source

Under the Health Act 2004, the Health Service Executive had its own Vote. In other words it was funded through a separate process from the Department of Health. The programme for Government contains wide-ranging commitments regarding the reform of the health services and the dissolution of the HSE is a necessary step in the process of implementing these reforms. The Health Act 2004 provided that the Minister for Health had no legal role in setting the HSE budget. The intention then was to give the HSE greater operational autonomy from what was characterised as a very politicised decision-making system. It is clear, however, that in the years since this was done the health service has been weakened because the accountability of the HSE to the Minister and the Department of Health was lacking. The Bill seeks to rectify that situation by restoring the Vote of the HSE to the office of the Minister for Health and thus re-establishing appropriate and proper accountability for the HSE to Government. It is another step on the way to necessary reforms, including the dissolution of the HSE, the establishment of a health commissioning agency, new community care structures, and hospital trusts.

The Bill provides for the disestablishment of the Vote of the Health Service Executive from January 2015 and from that date the funding of the executive will be mainly through the Vote of the Minister for Health by way of grants paid to the executive. The executive will continue to collect the income it generates through statutory charges, superannuation contributions and other miscellaneous income. The director general of the HSE will become an accountable person rather than an Accounting Officer. The Bill sets out an alternative statutory framework to govern the funding of the HSE and to ensure that the director general exercises proper controls on expenditure. The Bill also makes consequential changes to the service plan process to align it with the new budgetary arrangements. I look forward to speaking on the service plan when it comes before the House soon.

The central aim of the health reform programme is to improve equity and access to services. This Bill is an essential part of that goal. Transparency and accountability around service delivery are fundamental to the health service reform programme. This Bill, together with the other changes being made, will help ensure more accountability during the time the HSE continues in existence. I welcome this Bill which will, I hope, bring stronger control to the overly-bureaucratic HSE that has removed accountability from the provision of health services and has taken accountability away from the political authority and through that from the people.

Before I was elected to this House I was a local authority member of the Dublin North East Regional Health Forum, which replaced the health board. It was purely consultative in nature and had no real decision-making powers or functions. I seriously question its effectiveness.

I pay tribute to the individual staff members of the HSE who work very hard. The HSE model has not worked, as the last decade has shown clearly. It is too large and unwieldy to function in a cohesive and consistent manner. It is time to move on and take a new approach. I support the Bill.

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