Terence Flanagan (Dublin North East, Fine Gael)
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Question 81: To ask the Minister for Health and Children if she will provide details on her decision to dismantle the structure of the Health Service Executive into nine regional health authorities; the advice she has taken on the matter; the reasons for making this change; and if she will make a statement on the matter. [42517/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The HSE was set up to manage and deliver health and personal social services. One of the core objectives of the health reform programme was to provide clear lines of accountability and to simplify structures. I have made it clear on many occasions that I want to see health and personal care provided to patients on an integrated basis. I have also made it clear to the HSE that there needs to be accountability for performance throughout the system from the ground up. Reform on this scale is a dynamic process. There must be accountability throughout the system to deliver on national policies and standards. This will not happen unless there is real delegation of authority and accountability to regional and local level.

The HSE has informed the Government that it is proposing to put in place a regional model, within the national structure, to drive operational performance and accountability on the ground. It has not yet finalised its proposals for such a model. This is as much about good governance and consistent delivery as structures. It does not mean a dismantling of the existing structure; on the contrary it is about building on the progress to date in reforming the old health board delivery system. It means that, within a national structure, authority for operational performance is delegated to regional level. It means that people at regional level will be accountable for the resources provided and the services delivered at that level. It means better clinical leadership at national and local level. I believe that people working within the system must know what is expected of them and also have the authority to do their jobs properly.

I hope it is clear from what I have said that there will not be any regional authorities or any other autonomous structure within or instead of the HSE. There is ongoing discussion between my Department and the HSE about the planned structural changes. I want to be satisfied that the changes improve operational performance and accountability and that they are compatible with the configuration of other public services at local level.