Bernard Durkan (Kildare North, Fine Gael)
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Question 15: To ask the Minister for Health and Children if the Health Service Executive in its present form is capable of delivering a comprehensive health service to the people here in the foreseeable future notwithstanding the dramatically increased costs to the taxpayer, the employment of an extra 30,000 staff and the commissioning of numerous reports; if a cost benefit analysis has been undertaken to compare today's costs and delivery of service with those of the health boards; her views on whether the term centre of excellence should apply to all hospitals and institutions operated by the HSE with a view to delivery of the highest quality service to the growing population in a manner equal to that available in other EU countries; and if she will make a statement on the matter. [22276/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health Service Executive is capable of delivering a comprehensive health service. It is essential that the Executive concentrates on delivering safe, cost-effective services from within its existing very substantial resource base. The services and targets to be provided by the HSE in 2008 are set out in the national service plan, which I approved in November 2007 and the addendum to the service plan which I approved in February 2008. Both of these documents have been laid before the Houses and published.

The Annual Output statement demonstrates that substantial progress has been made in the delivery of health services. Only by continuing to push forward with and supporting an agenda of reform within the health services can we deliver the kind of health service we all want to benefit from within the resources that are available to us.

The gross provision for the Health Service Executive in 2008 is €14,337 million revenue and €594 million capital. The challenge is to transform this investment into tangible benefits for patients and staff so as to deliver the world class health service that everyone wants and that this level of investment warrants. The issue of cost benefit analysis in the context referred to by the Deputy does not arise. We are striving to improve the value for money element of this investment, developing a system that provides real incentive for good performance by the HSE itself and by its service providers.

The Government and I are working with the HSE to develop the appropriate staffing levels for the job that is to be done, in front line services as well as in administration. In the period December 2004 to March 2008, direct frontline service staff, in both the HSE National Hospitals area and Primary and Community Care have increased by about 10% while HSE Corporate staff levels have been reduced by more that 10%.

Reports and consultancies commissioned by the Executive are a matter for the Executive and it's Board. The level of reports commissioned is not unreasonable given the size and complexity of the organisation and the breadth of the reform programme being undertaken.

Centres of excellence or specialist centres should and will apply to all hospitals and institutions operated by the Health Service Executive. The reform agenda has to be supported by structural change in the health system, as well as by improved management actions and changed work practices in providing services to patients. This change is happening on a number of fronts such as the first full modernisation in 30 years in the Medical Council and the regulation of doctors and the modernisation of the law regulating the pharmacy profession and health and social care professions with the putting in place of a fundamental new contract for consultants for the first time in 30 years. The establishment of HIQA and setting standards progressively that will be monitored and implemented is also a crucial development in achieving excellence in health care settings.