Colm Burke (Fine Gael) | Oireachtas source

I agree with my colleague on the importance of patient advocates. It is also important to realise that this board will manage a budget of €17 billion. Many of these boards often rely greatly on advice from management, particularly from the chief executive. A board member needs to have the capacity to challenge and to make sure that the information that he or she is getting from the management team is correct and accurate. It is important that people have those skills.

Some of those decisions can be difficult because if one decides to progress one area, one might have to make a decision not to progress another area. It is important that one has people who have the skills to help everyone to work together. One of the problems that we currently have with the HSE is that everyone is defending their own part of the system and people are not working together. Whoever we put on a board should be able to work with, and challenge, management to ensure the correct decisions are being made.

While I have no difficulty in holding certain aspects of meetings in public, I am concerned about having all meetings in public, in particular, when decisions are being made that may not be what the public may want to hear. When one is managing a system like this, difficult decisions have to be made that people will not like. They have to be made, however, in the best interests of developing the proper and best level of healthcare that can be provided in this country. I am not satisfied.

We have reached a budget of €17 billion, which has increased substantially over the past three to four years. I stated this morning on the radio that we have an extra 12,000 people working now in the HSE compared to December 2014. That is greater than the entire workforce of the Army, but I am not clear that there was an overarching strategy by the HSE over the past four years regarding the key areas to deploy people.

A board, likewise, will have to make policy decision on the areas that need to be prioritised when bringing in new skills and how to help to co-ordinate management in ensuring that decisions are made in a timely manner. This is not the position now. I find that I go from A to B to C to D to try and get a decision. Some 18 months later, I find no decision has been made.

I had an interesting meeting in the past week concerning a facility, Cuan Mhuire, which cost €2.1 million in 2007. This brand new facility was purchased to provide a service and 18 beds are available in a house that was refurbished and fully equipped. For eight years, it has been lying idle because the HSE cannot make up its mind. There has been a failure to reach agreement about how we go forward. This is exactly what we are talking about. A sum of €2.1 million has been tied up since 2007, without anyone benefitting from that expenditure. That is exactly why a new board is so important to making decisions in a timely manner and ensuring that everyone down the line also makes decisions. It is not a case of passing from one section to another. We need to get into the entire health service to ensure that we can deliver the type of care that we require in this country.