Kathleen O'Meara (Labour)

I move amendment No. 9:

In page 15, subsection (1)(a), line 21, after "appointed" to insert "or elected in accordance with regulations made".

Section 11 refers to the membership and role of the board. This group of amendments refers to several issues in that connection which I will set out. Amendment No. 9 concerns elections, amendment No. 10 proposes that the chief executive officer should not be part of the board, amendment No. 11 proposes "Election of members of the Board shall include election by panels of professional and staff interests". Amendment No. 12 is not mine, amendment No. 13 deals with conflict of interest and amendment No. 14 deals with gender balance.

The legislation does at least refer to gender balance but our amendment goes somewhat further than the vague aspirations contained in the Bill and makes it specific, which is necessary in light of our experience of appointments to State boards.

The Minister of State will agree it is necessary to be specific rather than having a general aspiration if one is to achieve gender balance.

Senator O'Toole referred to the legislation as quite vague with regard to those appointed to the board. There will be 11 members appointed by the Minister in accordance with section 11, among them the chief executive. There is a case to be made for the chief executive not being a member of the board. This pertains in many cases. The role of the board is the creation of policy and the implementation of policy is the role of the chief executive. I would go either way, but it is worth looking into.

I would like the Minister of State to explain the rationale behind the chief executive being a member of the board. He or she will be a very powerful individual, not only controlling the board and budget of €11 billion but also having an extraordinarily demanding role in overseeing administration of health services and all it demands and requires.

The board is an important panel and will play a significant role. We do not know who will be on the board, although we know who is on the interim board. As Senator Browne pointed out, there is quite a banking influence. What is the Minister of State's vision with regard to the function of the board? It will be too late for us to do anything when the board is appointed, but it will give us an indication. However, I ask the Minister of State to be nice to us since it is Christmas. Perhaps he could give us some indication whether the final board will reflect the make up of the interim board or whether it will reflect a different set of interests. One would expect the big interests in the health sector to be represented, for example, consultants, doctors, nurses and health service workers. Will the voluntary and community sector be represented? Will the board be dominated by bankers or economists, people whose bottom line relates to the figures on the page?

Nobody would argue with the importance and necessity of value of money, efficiency in how it is spent and the elimination, as far as possible, of waste in health service spending. I have been raising a fundamental point since the start of this debate at 3 p.m. today. The mission statement has not been set out in this legislation. In its absence, one wonders how the board will see itself functioning. Can the Minister of State say what the board will look like?

The election of board members is not provided for in the legislation. I ask the Minister of State to consider its inclusion. Senator Browne supplied me with an article by Fintan O'Toole which recently appeared in The Irish Times. In it he refers to an earlier document written in advance of the appointment of the health service executive. It states the Department of Health and Children published a consultants' report on the process of establishing the HSE. The report stated the HSE would have the confidence of the stakeholders, workers, GPs, etc. Clearly that is not the case at this time.

One way to ensure it happens is set out in amendment No. 11 which states "Election of members of the Board shall include election by panels of professional and staff interests". The issue of election of members to the board should not be ruled out at this stage. The process would include whole sectors which would form part of it. Ministers have talked of a consultation process. What better process than a democratic process of electing members to the board? Not all must be elected. That would entail too large a body of work. However, what prevents professional and staff interests electing members? Such a measure could do nothing but good, and would in no way undermine the functioning of the board.