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Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: In that case, I will ask a different question. Let us assume it will not happen properly this year. I acknowledge the Minister of State is reading out the answers with which she is provided, but her answer would not fill anyone with confidence that the process will be in place this year. If the HSE is not sufficiently resourced to do it this year - and it does not seem that it will be -...

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Again, I acknowledge that the Minister of State is reading out the answers with which she has been provided. However, three minutes ago, she said the health needs assessment does not happen but she is now saying it does happen.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Yes. I do not believe that the resources will necessarily be in place. It does not appear to me that the requisite preparations are being made. If we assume they fail, are there any penalties or implications for the board, the CEO or anyone within the HSE for failing to comply with being able to present this report properly?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I thank the Minister of State.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I move amendment No. 5: In page 7, line 17, after "members" to insert ", who shall include a patient advocate, a financial expert and two clinical experts". We may disagree with each other later, Chairman, but we are in agreement this morning.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I am concerned that the board will not have the requisite representation on it. I took on the health brief this time last year. I was shocked when I looked at the executive team of the HSE, and, as it had been for the previous few years, only recently had a clinical lead been added to the senior team, which is extraordinary for a healthcare system. Just as worrying, there was no patient...

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: The problem with that response is that it is not matched in reality. The board does not currently have the correct skill mix. Members have been appointed to the board who have zero experience in healthcare. It is beyond me what they are doing on that board. There is no mandated position for a patient advocate. One member has patient advocacy listed as one of his or her responsibilities....

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: The question I asked was: who on the board is representing the clinical community, namely doctors, consultants, nurses, midwives and allied health professional? Where is that representation?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Does the Minister of State believe that the clinical community should be represented on the board?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Does the Minister of State believe that the clinical community should be represented on the board?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Does the Minister of State accept that there is no one on the board representing the clinical community?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: This is Committee Stage of legislation relating to the HSE board. With the greatest respect, the Minister of State should know who is on the board.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I can tell the Minister of State that no one on the board represents the clinical community because prior to Committee Stage, I looked at the board. There is no one representing the clinical community and there is no mandated patient advocacy. The Minister of State is saying that we should not get into specifics but the entire Bill relates to specifics.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: This is specifics about board positions. We are not going to name the individuals but we know what happens on a board without mandating clinical representation, patient advocacy and financial expertise because it has just happened.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: We have made the argument. I acknowledge that the Minister of State has been asked to step in at the last minute and perhaps did not know she was coming in today, so my remarks are no reflection on her. She has been asked to come in by the Minister. However, I believe that, in a discussion on legislation to reinstate the board of the HSE, it is pretty extraordinary that the Minister did...

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I am not entirely clear on the wording. I want to see whether the Minister for Public Expenditure and Reform is still included. If I understand it correctly, section 21A(3) of the principal Act would read that the CEO shall hold office upon and subject to such terms and conditions as may be determined by the board with the approval of the Minister with the consent of the Minister for Public...

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Is this a policy change? It appears that it is. The Bill states that the CEO shall hold office subject to terms and conditions determined by the Ministers for Health and Public Expenditure and Reform. This is what it currently states but it is being changed to read that the terms and conditions will be determined by the board as opposed to the Minister for Health. This is a policy change....

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: I accept that. My question is why that is the case.

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Would it allow for the board to set, for example, a pay level above public service caps?

Select Committee on Health: Health Service Executive (Governance) Bill 2018: Committee Stage (20 Feb 2019)

Stephen Donnelly: Many people have interviewed for the job and my understanding is that no one has been accepted. Some people are stating that we need to increase the salary on offer significantly. Would the amendment change the boundary conditions or constraints? I am trying to understand this. The amendment would mean that the Minister will no longer set the terms and conditions and that they will be set...

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