Thursday, 19 November 2015
Department of Health
The comments referred to by the Deputy were made in the context of current reorganisation of Ireland’s healthcare delivery structures and, specifically, the Hospital Groups transitioning to more autonomous Hospital Trusts in the future. The reform is not about privatising hospitals. This Government does not support the privatisation of hospitals which will continue, in the main, to be funded by the public purse. The majority of work will continue to be conducted by the public sector.
In advance of the development of Trusts a strengthened Accountability Framework has been developed by the HSE, which includes specific targets across the Balanced Score Card of quality, access, finance and HR and timelines for achievement. One of the most important elements of these accountability arrangements is a requirement that managers at each level ensure that any issues of underperformance are identified and addressed at the level where they occur. Where there are issues of persistent underperformance, the HSE will implement a formal Performance Escalation, Support and Intervention process as part of its Accountability Framework.
The key point to note here is that if Hospital Groups and Trusts are to have more authority and autonomy (to the extent that any organisation funded by public money can be), they will have to be more accountable. Where hospitals fail to meet performance targets which others can and where the reasons are internal, as distinct from other causes, then this needs to be tackled. The taxpayer legitimately expects results when their hard earned money is invested, whether in health or elsewhere. When additional resources are invested, patients have a legitimate expectation that questions will be asked if improvements are not secured and actions taken.