Jan O'Sullivan (Limerick East, Labour)
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Question 46: To ask the Minister for Health and Children her views on a report issued by the Department of the Taoiseach under the auspices of the Organisational Review Programme (details supplied); her plans to review and refocus the work of her Department; and if she will make a statement on the matter. [10661/10]

Mary Harney (Dublin Mid West, Independent)
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At the request of the Department of Health and Children, a review of the Department was carried out last year under the organisational review programme, ORP. The report of this review was received approximately four weeks ago and the Department is now preparing an action plan which will set out its response to the ORP conclusions. The report and action plan will be published in due course along with similar reports and action plans for other Government offices and Departments, following submission to the Government.

The ORP is a public service modernisation initiative under the auspices of the Department of the Taoiseach. It involves assessing the capacity of individual Departments and major Government offices to meet their challenges over the coming years. It is essentially a management tool which can be used by Departments to help them improve their performance.

While it would be inappropriate to comment on the report in advance of its consideration by Government and publication, the Department has already made it clear that it welcomes this report and is satisfied that it provides a timely and helpful review. The report acknowledges the Department's strengths and achievements including, in particular, the ability and commitment of its staff in dealing with a difficult agenda.

It also identifies areas which require improvement, including the need to clarify its roles and responsibilities particularly vis-À-vis the HSE; manage delivery by its agencies through stronger goal setting, output and outcome measurement and performance management; define its customers and stakeholders more clearly and align itself to serving these appropriately; and improve its human resource capacities.

I am confident the Department will respond effectively to the ORP report and will use it as intended, to build on its undoubted strengths and to further improve its performance in these changing and challenging times.

Jan O'Sullivan (Limerick East, Labour)
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I note the Minister stated she cannot comment because it has not been published. Is the account published in The Irish Times on Thursday, February 18 accurate? It depicts a lamentable account of mismanagement and disorganisation in the Department, which indicates that some people have too much to do and other people do not have anything to do. It suggests that there should be more of a focus on the main stakeholder, namely, the patient. Will the Minister comment on that? Why has it taken so long to reorganise the Department given that the Health Service Executive has been in existence for five years? Presumably that should have been enough time to reorganise the Department. Given that the functions, in essence, have been passed on to the Health Service Executive, does the Minister consider that 436 core staff are required in the Department? Why do staff spend so much time on Oireachtas business especially as most of our questions are passed on to the Health Service Executive?

Mary Harney (Dublin Mid West, Independent)
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The number of staff in the Department has reduced by 25% since the Health Service Executive was established. The Department was never an operational Department. In the health board era it was never involved in operational issues. A myth has arisen in this regard. The Accounting Officer role has changed. The chief executive officer of the Health Service Executive who spends the money is accountable to the Oireachtas for the expenditure of that money. That is an appropriate management tool and although it has been criticised in some quarters it has been very much praised in another. It is not acceptable that a Secretary General of a Department who is not responsible for the expenditure of money and operational issues should have remained the Accounting Officer.

The huge change in the Department was acknowledged in the report. Unfortunately, the report was leaked. I say that because the staff in the Department were entitled to hear from management on the outcome of the report before they read it in a newspaper but someone chose to leak the report and we have to deal with that. The role of the Department has changed immensely. For example, until recently the medical team in the Department led by the chief medical officer had an advisory role; now the chief medical officer heads up a division of the Department and has management responsibility for patient safety. That is the division dealing, for example, with the upcoming licensing and accreditation of health facilities. The role has changed enormously. The report is full of praise for the Department in many respects, including the cancer policy, the cardiovascular strategy and the fair deal.

Deputy O'Sullivan inquired whether there are too many staff. Most Oireachtas Members who have an interest in this area were exposed to the team of three people who were involved not just in putting together the fair deal legislation but in discussing it with all stakeholders and other Departments. We are usually accused of not being accountable to the Oireachtas but we are one of the most productive Departments in terms of producing legislation. Last year four major Bills were produced and 12 Bills are in preparation. The Department deals with more than 5,000 parliamentary questions and 500 Adjournment debates. It is an extremely busy Department.

The head of the Department in this case is the Minister and the Ministers of State. The management team is led by the Secretary General. We are fortunate to have one of the most dynamic public servants of his generation. It is a matter for him and his management team to address the issue if it is the case that some people do not have enough to do and others at the lower levels have too much to do. That is not an acceptable position from management's perspective and the Secretary General and his team intend to deal with that.

Jan O'Sullivan (Limerick East, Labour)
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I acknowledge the work of the staff who are dealing with a fair deal. They have been particularly helpful in that regard. I do not wish there to be any doubt on that.

What we read in the newspaper indicated much chaos with some people having too much to do and others having nothing to do. Has the Minister commenced the reorganisation of the Department since that report was received?

I question whether many of the decisions being made by the Health Service Executive are implementation or policy decisions in so far as in times of budgetary constraints, deciding where the budget goes can in effect be a policy decision. What input does the Minister have on bed closures and on the various other decisions that impact on patients that are currently made by the Health Service Executive?

Mary Harney (Dublin Mid West, Independent)
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Traditionally, the Department over-concentrated on inputs. As is clear from the report, the role of the Department is focused on outcomes, results and measuring performance. The report draws attention to the need for the Department to have a different skill-set such as economic analysis and analytical skills in general. I share that view. The service plan has to be approved by the Minister. I agree that there is a fine line in many respects between policy and its implementation. The cancer control framework was a policy initiative of mine which was endorsed by the Government and implemented by the Health Service Executive. The Department has to be praised for that policy initiative. We need to see the Department involved in more of that.

Significant reorganisation has taken place. It is acknowledged that the Department and the Health Service Executive are on a journey in terms of how services are provided. Initially there is always a lot of nervousness about change but the working relationship between the Department and the Health Service Executive has improved immensely. I want to see that continue. I would be happy to arrange for Deputies to meet and engage with the management team. Members would see that they are made up of hard-working, committed, energetic civil servants who take that task seriously.