Emmet Stagg (Kildare North, Labour)
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Question 118: To ask the Tánaiste and Minister for Health and Children if her attention has been drawn to the widespread unease within the Health Service Executive at the repeated changes in administrative structures that have dogged the Health Service Executive; her views on whether it was foolhardy to establish the Health Service Executive without a CEO in place; the measures she is taking to ensure no industrial action will take place; and if she will make a statement on the matter. [35485/05]

Bernard Allen (Cork North Central, Fine Gael)
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Question 185: To ask the Tánaiste and Minister for Health and Children her views on the restructuring of top level positions in the Health Service Executive, its impact on staff and service delivery; and if she will make a statement on the matter. [35367/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 118 and 185 together.

I decided to proceed with the establishment of the Health Service Executive, HSE, with effect from 1 January 2005 to ensure that the momentum of the health service reform programme was maintained. Arrangements were put in place to underpin this. The chairman of the interim HSE was appointed as interim chief executive officer until such time as a CEO was appointed. In addition the chief executive officers of the former health boards played a lead role in facilitating the transfer of accountability and ensuring a safe passage to the new structures. Those CEOs who had not taken up other positions in the HSE agreed to remain in post until 15 June 2005 as chief officers for their respective areas. Professor Brendan Drumm took up appointment as chief executive officer on 15 August 2005.

An agreement was reached in December 2004 between the HSE and IMPACT, the union representing senior managers in the health boards, to assist co-operation with the new structures and the reforms generally and to provide for a genuine working partnership between IMPACT and the HSE in the interests of the users of services and the staff who ensure their provision.

I am advised that processes aimed at resolving any emerging difficulties are in place across the range of functional areas which form part of the HSE. In addition the HSE intends to have a communications and organisational development strategy in place from the start of next year and will seek to approach this in a participative fashion with IMPACT and other trade unions.

Significant progress has been made in bringing the HSE organisational structure to life and some restructuring has been necessary as the organisation bedded down and the health reform process took root. Decisions on the organisational structure are designed to: accelerate the pace of change within the HSE; involve clinical practitioners and patients in the development and monitoring of healthcare strategies; quickly deliver more relevant services to patients and clients; promote full and seamless integration between the main service-delivery units, National Hospitals Office and primary, community and continuing care, ensuring that patients can access services easily and that service-delivery is simplified; and provide greater job satisfaction to staff.

In this context, an assessment has been made by the HSE in relation to the organisation of acute hospital services on the basis of ten networks and all other health services on the basis of four regions. Reconfiguring the administrative regions in relation to acute hospitals has been identified as one of the revisions needed.

Reform of this magnitude will not be without some initial teething problems. However, we are already beginning to see the value of this fundamental reform in terms of accountability and decision-making with the HSE having both management and financial responsibility for our health service operations. I am determined that the pace of health reform matches the pace of funding increases. This is the key to ensuring better services, better value for money and taxpayers' support for further health spending increases.