Victor Boyhan (Independent) | Oireachtas source

I welcome the Minister for Health and acknowledge his simple but comprehensive and clearly laid out report. As we know, the Oireachtas Committee on the Future of Healthcare concluded that we needed an independent board for the HSE and this also ties in with Sláintecare. I welcome this positive legislation. The Library and Research Service has produced a comprehensive digest, which I recommend it to all Members as it sets out the position very clearly. It also places great emphasis on transparency, accountability, integrity, the participation of stakeholders in the broadest sense and also policy capacity. These are the key issues that the Minister has already outlined.

In 2011, the soon to be Minister, Senator James Reilly, stated that under his watch the existing "monster of the HSE" would be abolished. At the end of April 2011, the then Minister stated that the HSE board and its sub-committees were established by his predecessor to "put distance between the minister and their responsibilities." He added that he would shorten "that chain of command with this new change". This, he said, would be "for the betterment of the patients". Senator Reilly is not here today and I fully understand if he is on other business. He made these remarks following the voluntary resignation of the board of the HSE, a decision which was largely driven by his rhetoric. The board was replaced by an interim board. It was not until the Health Service Executive (Governance) Act 2013 commenced on 25 July 2013 that the Minister formally abolished the board of the HSE. Speaking in the Seanad in September 2012, the then Minister stated the purpose of the Bill was "to make the HSE more directly accountable to the Minister for Health, who in turn is accountable to the people through the Oireachtas". Seven years after the forced resignation of the HSE board and five years after it was legally abandoned, we are re-establishing the board. That is an important point to make. I have no problem with people doing U-turns. The reality is that the main element in the current Administration has been in power for the past seven years.

One of the consequences of the reckless governance structures in our health service for the past seven years was made plain in the recent report by Dr. Gabriel Scally. It states:

In 2013, legislation changed the nature of the governance of the HSE entirely, replacing the Board structure with a Directorate consisting of a Director General and no fewer than two, and no more than eight, Directors all of whom were HSE staff. The Director General and Directors were all effectively appointed to the Directorate by the Minister for Health. It is recognised that this was a step along the intended path of abolition of the HSE.

The following is important. The report continues:

The net effect was to remove external, independent input into the running of the HSE at its highest level... This change from the accepted good practice of having independent Board members in an oversight role, and involved in a committee structure beneath the Board, was a major move away from the established norms of good governance of public bodies. It is difficult to see who, under this configuration, was representing the patient and public interest.

I could go on but there is no point in doing so.

As we are here today, I want to express my deepest sympathies to the family of Emma Mhic Mhathúna. It is poignant and appropriate that her cortege, according to her wishes, should pass some Government Buildings and proceed to Áras an Uachtaráin. Ms Mhic Mhathúna made a courageous decision. Her death is only one of many and, sadly, in the weeks and months ahead, we will speak in the House about a number of other people who are due to pass away.

I commend the Minister on what he is trying to do. It makes sense to have new governance for the HSE. I am particularly impressed with the importance placed on the qualifications and expertise of members of the new board. I hope it will not be a political board but one based on merit, capacity and ability.

I repeatedly raise issues in the House and I do not intend to rehash them here today. I hope we will meet he Minister soon. We receive political feedback through parliamentary questions and in responses to Commencement matters in which we are told the issues we have raised are matters for the HSE. When we raise them with the Minister, we are told he cannot do anything about them. I accept that he has a lot of work to do in his extensive brief and has many responsibilities on his shoulders. His task is not easy. The sooner this legislation is enacted and the sooner we have an independent board that has the confidence of the people and, more important, the confidence of its users as well as the practitioners and clinicians involved in the delivery of a broad range of health services, the better. I wish the Minister well.