Pat Rabbitte (Dublin South West, Labour)
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Question 91: To ask the Minister for Health and Children her plans to introduce regional structures and integration of acute and PCCC care in these regions; the timeframe for same; the addition or reduction of managerial staff that will result; and if she will make a statement on the matter. [42449/08]

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 be 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 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.

The internal structural changes proposed for the HSE will be considered by the Government when they are finalised and submitted to me by the Board of the Executive. The Government will want to be satisfied that the proposed changes will improve operational performance and accountability, and that they will sit comfortably with the configuration of other public services at local level.

The purpose of the structural changes is to optimise operational capability and to have clear lines of authority and accountability for delivering services to patients from national to local level. The new structure in the HSE will be leaner and there will be a focus on de-layering and more efficient working at all levels. I firmly believe, and I have said this before, that a managed voluntary early retirement/redundancy scheme will have an important role to play in helping to streamline management within the HSE and, as a result, in improving the delivery of health and personal social services to patients and other users of our public system. The HSE is working on a value for money assessment of the case for/impact of such a scheme along with an indication of its expected scale and timing.