Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister to the House and I welcome this Bill. I always believed that the HSE should have a board and welcome this change in how the HSE should be managed into the future. We need a proactive board that is comprised of people that have business or legal expertise, which I have said previously. Major decisions are made on a day-to-day basis and, therefore, it is important that the chief executive has a board that is decisive and can consider the overall management of the HSE.

The health budget is €17 billion so it is not a small budget. Neither I nor the ordinary person in the street would be familiar with managing such a budget. The work involves managing finances, staff and the various tiers that we have created in the HSE over the past number of years. When one considers that 17,600 people work in the administration and management, and there are 7,500 nurse managers out of a total of 111,000 people in the HSE, I would be concerned about the structures that we have allowed to be created over the past ten or 15 years. Yes, there is a need for more staff but there is also a need to develop new roles for staff. For instance, we have changed the qualifying criteria for nurses. They have academic degrees, a huge amount of experience and they also have qualifications in patient management. In many cases, one now finds that nurses have a lot more experience than junior doctors yet nurses are dictated to by junior doctors. We have not designated new roles for nursing staff, which is something that needs to be changed in the process.

We need a board of management that will bring about the necessary changes in a whole lot of areas, not just managing finances but how we manage individual hospitals and individual sections of the HSE. We should not tie such work to any one group. I have no difficulty with patient advocates being on the board.