Written answers

Tuesday, 8 July 2008

Department of Health and Children

Health Service Reform

11:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 285: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to review how effectively the Health Service Executive is operating and, particularly, to ensure that team work and communication are working to the fullest extent; and if she will make a statement on the matter. [26803/08]

Photo of Tom HayesTom Hayes (Tipperary South, Fine Gael)
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Question 372: To ask the Minister for Health and Children when the review of the Health Service Executive will take place, including structural reform; if there will be a possibility of redundancies highlighted in this review; and if she will make a statement on the matter. [27411/08]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 285 and 372 together.

The HSE is making progress in the integration of a large number of health sector agencies, in setting and implementing consistent performance standards, and in improving patient care across many different service areas.

The HSE endeavours to make constant and continuous improvement. To this end, I meet with the Chairman and CEO of the Executive regularly.

In this context, I wrote to the Chairman of the HSE last March, on foot of the report into the handling of events at Portlaoise. I asked him to consider whether the governance and management issues which had been identified in relation to the events at Portlaoise had wider application across the HSE. I acknowledged that the Board had already been considering these issues and I asked for this work to be expedited.

The Chairman wrote to me about these wider governance and management issues on 27 May and outlined for me the key elements of a proposed new management structure. In summary, this will involve:

a Director of Service Delivery who would be responsible for all service delivery and head up a single integrated NHO/PCCC pillar with a team of Area Service Delivery Personnel;

a Director of Planning with a team of national care group/programme managers covering children, older people, disability/mental health, acute hospitals and primary/community care who would be responsible for setting corporate policy/standards in all these areas and driving performance against these standards;

a Director of Clinical Affairs who would drive engagement with clinicians and be responsible for quality/risk, and defining national clinical standards/protocols;

a Director of Communications who would be responsible for all communications including parliamentary affairs;

and the retention of the existing Directors of Finance, HR, ICT, Estates and Procurement.

The Chairman explained that these changes are designed to:

maximise operational excellence and effectiveness in service delivery;

facilitate integrated service delivery for the benefit of patients and to optimise efficient use of resources;

enable a single national strategic approach with local (area) responsibility for service delivery;

ensure clinical engagement at all levels; and

create a lean organisation with clarity of roles and accountability.

The implementation of these new management structures will necessitate a clarification of associated staffing implications below National Director. In line with the Government's decision today, this will include developing a voluntary redundancy scheme to streamline the number of management layers and positions. This scheme will be subject to consultation, will require the prior approval of the Minister for Finance and will operate on a voluntary basis. It is to meet the test of delivering value for money.

The purpose of the new structure is to make operational decision-making clearer and more efficient. It will allow those charged with service delivery to take a far more active role in delivering services within budget and staffing limits. National strategies will remain at national level.

I am committed to the review of the Health Service Executive as set out in the Programme for Government and to ensuring that staff will have an opportunity to propose ways in which the HSE can work more effectively. To this end, I expect the Executive will:

focus intensely on implementation and service delivery, with clear lines of management accountability internally, and a concentration on short-term deliverable changes which are consistent with overall policy;

develop a locally responsive system of service delivery within a consistent national framework;

have an integrated and patient-centred approach to service delivery, by enhanced team working internally and with care groups, professions, etc.;

strengthen its communications with the Oireachtas; and

strengthen its communications with staff, the general public and the media.

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