Bernard Durkan (Kildare North, Fine Gael)
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Question 15: To ask the Minister for Health the policy making or formulation structure in the health service; if policy emanates from him or the Health Service Executive or a combination of both or otherwise; the way policy decisions are arrived at or by whom such policies are influenced in such matters as hospital restructuring such as increase or diminution of services or facilities, the location and or facilities such as health centres including capacity criteria for up or downgrading, the structures most influential in reaching such decisions and national, regional or local level; and if he will make a statement on the matter. [26315/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 154: To ask the Minister for Health the various policy making structure within his Department or the Health Service Executive; the methodology used in the determination of policy at all levels with particular reference to general hospitals, special hospitals and community care services; the extent to which particular policies have changed over the past ten years; the reason for such change; if the need under each or any heading has grown or diminished in the period; and if he will make a statement on the matter. [26626/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 162: To ask the Minister for Health the policy structure in his Department and or the Health Service Executive with particular reference to clarification as to the way policy is formulated in current or future provisions in respect of the various disciplines at national, regional or local level; and if he will make a statement on the matter. [26634/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 164: To ask the Minister for Health the extent to which he interfaces with the Health Service Executive or others involved in policy making with particular reference to the determination of policies at local or regional level particularly those affecting the location and delivery of services at local health centres; and if he will make a statement on the matter. [26636/11]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 15, 154, 162 and 164 together.

At present, my Department has primary responsibility for advising me on issues relating to national policy development and review while the HSE has primary responsibility for the delivery of health and personal social services, including regional and local operational issues relating to the location of particular services.

I believe there is a need for greater clarity about the respective roles of the Minister/Department and of those charged with the delivery of services.

The interim HSE board which I established last May was designed to facilitate greater integration between the senior management teams in my Department and the HSE. I made it clear at the time that I intend to seek Government approval to draft legislation to abolish the board of the HSE and put alternative governance structures in place. My Department is currently preparing policy proposals in that regard for my consideration.

While I would not wish to pre-empt the outcome of this process, I believe we need to make it clear that the Minister is responsible for defining the framework within which services have to be delivered. This would include issues such as funding and financial incentives, service delivery models, and standards relating to performance management, quality and access. Equally, we need to ensure that those charged with the delivery of services have the authority to make the operational decisions required to deliver an agreed quantum of services within budget and in accordance with quality and access standards set at national level. We need to delegate authority as close as possible to the point of service delivery, ensure that such authority is exercised within clear national standards and hold people to account for their performance in that regard.