Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I will. With regard to accountability, I appreciate the point Deputy McGuinness makes. I am clear on what I am accountable for but there are other people accountable for other elements of the health service. When I ask for them to be held to account and for them to redouble their efforts, I do not mean it to excuse me of my responsibilities. When I talk about accountability, I am talking about trying to identify the fact there is good practice and really good stuff happening in parts of the health service. However, if we do not look at the system and who is doing well, we cannot replicate that good practice. We have seen it in Beaumont Hospital and in the RCSI group, and Deputy Rabbitte pointed out the good practice in regard to some midwifery services in Limerick.

We have a performance and accountability framework. It is a document that every manager in the health services signs, and it is agreed by the Department of Public Expenditure and Reform, the HSE and the Department of Health. It states that managers must be held to account on four scores, one of which is financial. Deputy McGuinness and I would have talked about this a lot at the Committee of Public Accounts and the system is getting quite good at holding people to account on the financial side. However, the other three pieces are what matter to the people in the "RTE Investigates" programmes, and involve things like timely access, quality and the safety of the service. I have written to the director general of the service to say I want to know how each manager measures up against that balanced scorecard in regard to those four things, not just the financial piece.

Yes, I believe the HSE needs to be reformed. What I do not think needs to happen, and I hope the House would agree on this, is that another Minister for Health would just tweak the structures. In due course, hopefully in quite a while, we will have another election and perhaps a different Government. Deputy Billy Kelleher might one day be Minister for Health and might decide to change the system, and Deputy Louise O'Reilly might then be Minister, and she might decide to change it again. We need to have a cross-party plan for ten years in order that the structure does not keep changing no matter who else changes. I hope and expect that the Committee on the Future of Healthcare will give us that structure and I am committing to the House that we will then implement that structure. Let us then try to legislate for accountability and for governance, and let us try to address the piece that has been brought up time and again about the accountability of health service managers and executives to public representatives on behalf of their constituents and communities.

I will look into the points raised by the Deputy in regard to St. Luke's and the correspondence he has given me in regard to Galway.

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