Tony Gregory (Dublin Central, Independent)
Link to this: Individually | In context

Question 201: To ask the Minister for Health and Children the financial savings that have been made in the administrative areas, both staffing and accommodation, by the absorption of all health boards into the Heath Service Executive. [22978/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

As the Deputy will be aware, health services in Ireland were, for many years, delivered through a combination of public, voluntary and private suppliers. Eight Health Boards were established under the Health Act (1970) to provide health and personal social services for the population. The Eastern Regional Health Authority (ERHA) was established on 1 March 2000, replacing the Eastern Health Board. The ERHA comprised three area health boards which covered the same region as the former Eastern Health Board.

Apart from the establishment of the ERHA in 2000, the system of delivery of health and personal social services remained unchanged for over thirty years, during which time the complexity of services and the degree of inter-working between different agencies and sectors had greatly increased. The location of specialist and tertiary level services and the planning of new services had a regional rather than a national focus. There were inequalities in the level of services provided in different health board areas and inconsistencies in the interpretation of eligibility for services. Duplication of services in adjacent areas and lack of provision in other areas occurred. Different and incompatible IT systems were developed in different health boards and in voluntary hospitals, making the sharing of information difficult or impossible. Administration costs in supporting what were, in effect, eleven different health boards were higher than necessary. The decision was taken to develop a new health strategy to review the existing situation and plan for the future of the health system in Ireland.

The Health Service Reform Programme, which was approved by Government in June 2003, outlined a range of reforms to help deliver a more responsive, adaptable health system that meets the needs of the population effectively and at an affordable cost. The reform programme comprises a range of reforms to help modernise the health services to better meet the needs of patients. The reforms are designed to achieve a health service that provides high quality care, better value for money and improves health care management. The structural aspects of the Reform Programme emerged largely from the recommendations in the Prospectus and Brennan commission reports and reflected Government decisions in relation to reforming the other areas outlined as Frameworks for Change.

Under the Health Act 2004, the health boards, Eastern Regional Health Authority and the area health boards were abolished and all staff, powers, functions and resources were transferred to the HSE. The HSE is tasked with delivery of health and personal social services through a single national structure. The Health Service Executive (HSE) is a unitary system, a single organisation delivering health services nationwide. This unitary system allows for clear accountability structures and modern financial management systems to allow key decision makers in the health service to link activities with budgets and thus to evaluate the effectiveness of their decisions.

The HSE is undertaking the task of unifying the formerly fragmented healthcare delivery into a single unitary system. The HSE has recently launched its Transformation Programme based on six transformation priorities which include:

developing integrated services across all stages of the care journey,

configuring primary, community and continuing care services to deliver optimal and cost effective results

configuring hospital services to deliver optimal and cost effective results

implementing a model to prevent and manage chronic illness

implementing standards based performance measurement and management throughout the HSE

ensuring all staff engage in transforming health and social care.

Some of these projects are already under way and most will have significant impact right across the organisation and will alter the way the HSE itself is organised. Indeed, the HSE continues their dialogue with some unions regarding the final configuration of staffing structures. All projects will be subjected to rigorous ongoing assessment, however, it is too early in the process to be definitive regarding overall financial savings emerging to-date.