Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I move:

In page 9, to delete lines 10 and 11 and substitute the following:“(c) 9 ordinary members.”.

These amendments arise from discussions on and an amendment accepted on Committee Stage to provide that ordinary members of the HSE board must include a patient advocate, a financial expert and two clinical experts. I acknowledge these were amendments from Deputy Donnelly. There was a debate and a focus in particular on clinical expertise in the context of board membership. I am proposing amendments which I believe meet the issues raised regarding this.

Amendment No. 3 provides that at least one of the persons appointed to the board must be a person who is practising, or has practised, as a member of a health profession, whether in this country or elsewhere. Amendment No. 6 sets out what is meant by a health profession. It covers doctors, nurses, midwives, dentists, pharmacists, as well as the health and social care professions regulated under the Health and Social Care Professionals Act 2005. I hope Deputies will agree this ensures the board includes membership with clinical expertise as was envisaged in the Committee Stage amendment. I listened to Deputy Donnelly’s compelling argument that it is important there is a designated space on the board for clinical expertise. It was never the intention to exclude that expertise. We went through the Public Appointments Service. I accept it is prudent and in the spirit of what Deputy Donnelly is trying to achieve in this regard.

Arising from this and the amendment made on Committee Stage, amendment No. 1 increases the number of ordinary members on the board from eight to nine. Amendment No. 2 is a technical drafting amendment to take account of the inclusion of the new provision of clinical expertise in amendment No. 3. Amendments Nos. 5 and 12 to 14, inclusive, are consequential to the increase in board membership, covering the quorum for the board and arrangements for calling board meetings.

My amendments would give scope for the clinical expert to be potentially the chair or the deputy chair of the board, whereas Deputy Donnelly’s amendment did not provide that the person could only be an ordinary member. There may well be a case where the clinical expert ends up being the chair or deputy chair of the HSE board. The amendment, as passed on Committee Stage, would not allow for that.

Also, the Bill, as passed by the Seanad, provides that at least two board members must be people with experience of or expertise in advocacy related matters affecting patients. The Committee Stage amendment would cause a conflict with these provisions which were included to meet the recommendations made by Dr. Gabriel Scally in his scoping inquiry into CervicalCheck. I do not believe anybody wants to have a conflict. Every Member is committed to implementing Dr. Scally's recommendations. There was an excellent amendment put forward in the Seanad by Senators Devine and Ruane to ensure that in law there are two spaces and it was not at the discretion of the Minister of the day. While it was not the intention, I am concerned about having anything in the Bill which would suggest that there should not be two patient advocates. My amendment reiterates that two of the seats should be dedicated to patient advocates, thus fulfilling an important recommendation of the Scally report.

I am not proposing to expressly provide for a financial expert on the board. The amendments made in the Seanad in regard to patient advocacy ensure it will always be part of the criteria for the HSE board membership. The amendment I am proposing on clinical expertise will ensure this too will always be part of the criteria for HSE board membership. Financial expertise, however, should be viewed in a somewhat different light. Unlike advocacy and clinical expertise, financial expertise is and must be a standard requirement for any board. Financial expertise will, therefore, feature as part of the HSE board membership make-up without the need for express legislative provision.

The Public Appointments Service campaign for HSE board membership sought candidates with experience and expertise in several areas, including financial planning and management. I hope to be in a position to make an announcement shortly in regard to a further board member with specific expertise in financial matters.

Deputy Donnelly's amendment on Committee Stage provided that the new board should contain a patient advocate. My amendment proposes two patient advocates. This will comply with the recommendations of Dr. Scally.

Deputy Donnelly proposed the new board should have financial expertise. I agree with him. I am giving an assurance that the vacant seat on the board will go to a financial expert. I hope to be in a position to announce that shortly.

Deputy Donnelly rightly said there should be one or two seats for clinical expertise. I am bringing forward a proposal that will allow for one.

My officials consulted the Office of the Parliamentary Counsel to ensure the Bill does not have any conflicts in how it is drafted. My concern is that the amendments passed in the Seanad could be legally conflicting with those proposed by Deputy Donnelly. I am trying to marry the spirit of what the Seanad and the Deputy were trying to achieve.

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