Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister. Fianna Fáil supports this Bill, which restores the HSE board. The 2012 decision to abolish the board was a clear mistake which was contrary to good corporate governance. The establishment of a board was also recommended in the Sláintecare report, which pointed out that good leadership and governance are critical functions of any health system.

The committee strongly stated there is a requirement for clearer clinical and managerial accountability and governance throughout the whole system. This includes clarity at all levels, from the Minister of Health and his Department to the HSE and all health providers. Sláintecare proposes that the HSE be reformed into a more strategic national centre with an independent board and fewer directorates. Recognising the international evidence on the negative impact of system re-organisation or merger, Sláintecare recommends that structural change should be as simple as possible, with only what is needed to meet the requirements of integrated care. An explicit recommendation of Sláíntecare is that an independent board and chair should be appointed to the HSE at the earliest opportunity by the Minister following a selection process through the PAS. Board membership should reflect the skills required to provide oversight and governance to the largest public service in the State. The chair of the health service board will be accountable to the Minister, and the health service director general will be accountable to the board.

I would like to echo some of the sentiments of various commentators following the budget yesterday that the implementation of Sláintecare lacked a certain urgency. I was disappointed the funding for the Sláintecare reform programme was not specifically identified in yesterday's budget, but I take on board the Minister's comments at last week's Committee on Health that progress will be made in the coming weeks, which I welcome. The recent Scally report on the CervicalCheck screening, which we discussed this morning at the health committee, noted how changes to the overall governance of the HSE itself had a significant impact on the CervicalCheck service. The report states: "It is difficult to see who, under this configuration, was representing the patient and the public interest." That is a fundamental, impactful statement.

I hope the implementation of this Bill will not only deal with the recommendations of the Sláintecare report but also address the anomalies set out in the Scally inquiry. One of the most important recommendations that I heard from the Scally inquiry was the establishment of the national screening committee to advise on any new programmes that may be required and, probably more importantly, to advise on any modifications of existing programmes. I welcome the establishment of that committee, and we support this Bill.