Dan Boyle (Green Party)

The second report of the organisational review programme is interesting in terms of the four agencies it has chosen. I refer to them in an order different from the report and will refrain from alluding to the elephant in the room until last. We should start in a positive sense. The Revenue Commissioners and the Central Statistics Office, CSO, highlight best practice in the area. We should recognise the improvements made in both organisations in recent years and put them forward as models for how other areas of the public service can be improved.

Interestingly, I believe the CSO, which is based in Cork, is the only positive example of the relocation programme. I have always had difficulty in describing it as "decentralisation" since in essence this is not a matter of moving from Dublin to another part of the country but rather about distributing the services. The CSO, however, was the only national organisation that could be moved to an out-of Dublin location and could still perform the same functions, as it has continued to do excellently. If any lesson is to be learned from such office relocation it is that it has been the wrong type of decentralisation. Having an office in Sligo and one in Longford for social welfare while maintaining centralised activities is not decentralisation. I hope future ORP reports will investigate how we might have offices throughout the country dealing with the local regions in the areas of social welfare as well as, perhaps, health and education.

The decision announced yesterday by the Tánaiste concerning the VECs is welcome. I am not sure whether a reduction from 33 to 16 is sufficient in review terms but it points things in the right direction. I hope the lesson that was not learned from the amalgamation of the health boards into the HSE, whereby everyone was reallocated to new positions, is not repeated with the VECs. It is an important lesson we cannot afford to overlook.

The report referred to the Property Registration Office which, in a sense, is somewhat in abeyance as it is subject to reviews elsewhere. It might be reviewed differently, perhaps, from the Land Registry and Ordnance Survey Ireland. The report is useful in highlighting what the office does well and could do better in a more expanded, streamlined structure.

The essential elements we need to learn from the ORP are where the critical mass lies and where economies of scale may be achieved. That is where we come to the sore thumb, as it were, in this particular report. It is no great joy to describe the Department of Health and Children in such a way. I believe several Departments are not fit for purpose, not solely because of structure but also because of culture. There is a mindset prevalent among many decent, well-meaning, well-serving civil servants to the effect that change needs to be slowed down and challenged. We have suffered from this in the past. The Department of Health and Children is one of the Departments that have been too slow to recognise the need for change. I hope the organisational review programme and the need to put its own action plan together will overcome many of the anomalies in the future.

One of the main difficulties has been that it is still well-served in terms of personnel. Several hundred people work in the Department of Health and Children for the sole purpose of producing policy. This has very little linkage with the actual delivery of health services. That is the role of the Health Service Executive, which many of us in public life have come to believe has failed in its reorganisation. Questions need to be asked about the best way of reorganising, whether it is to set up a new structure or reintegrate with the Department of Health and Children. Given the personnel within the Department of Health and Children, I would argue there is a better fit in bringing the health service back into central government and making use of personnel there rather than reinventing the wheel and creating new health boards.

That said, there are two levels in which the health services need to be provided. Community and primary care are best provided within local areas. Where health boards were successful was in delivering such requisite services. Economies of scale are needed, however, in terms of large facilities and the specialist policies that have been put in place for cancer care and other forms of specialised delivery. That would embrace the role of bodies such as Comhairle na nOspidéal in terms of how hospitals are built, their location and the type of services they provide.