James Reilly (Dublin North, Fine Gael)
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Question 153: To ask the Minister for Health and Children the number of health care regions and the geographical area they will encompass with regard to Health Service Executive reforms; the extent of streamlining management levels envisaged; and if she will make a statement on the matter. [28742/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The revised management structures being introduced by the HSE are designed to facilitate:

more local responsibility and authority within defined national parameters;

greater clinical involvement in the design and management of patient services; and

improved integration of primary, community and acute care for the benefit of patients and to optimise efficient use of resources.

As national level, the new structures will involve:

a Director of Service Delivery who will 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 will be responsible for setting corporate policy/standards in all these areas and driving performance against these standards;

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

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

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

The next steps in the process are to finalise the number of service delivery areas and define their boundaries; secure buy-in from all stakeholders, including relevant unions, and to implement the new structures as soon as possible.

It will also be necessary to review and modify the clinical and support structures at area level to reflect the adjustments at corporate level. The aim, however, will be to ensure that the Area Directors will have operational responsibility and authority to deliver all hospital and community care services, and personal and social services, in their specific geographical areas within their budgets and employment allocations.

This approach will strengthen and simplify area governance. It will also ensure more efficient and responsive delivery of local services and facilitate more local responsibility, authority and decision making within defined national parameters.

The implementation of these new management structures will involve a clarification of associated staffing implications. 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. It would not be appropriate at this stage to speculate on the extent of the streamlining but the aim is to create a lean organisation with clarity of roles and accountability.