Written answers

Thursday, 5 March 2020

Department of Health

Health Services Reform

Photo of Seán FlemingSeán Fleming (Laois-Offaly, Fianna Fail)
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511. To ask the Minister for Health if existing reconfiguration plans under the health strategy are superseded by Sláintecare; the details of the categories of reconfiguration plans in general hospitals that have been superseded by Sláintecare; and if he will make a statement on the matter. [2608/20]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I understand that the Deputy is referring to proposals as part of the Sláintecare reform programme to reconfigure the HSE.

A clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, complemented by the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.

As the Deputy will be aware, there are currently separate regional management structures in place within the HSE for hospital and community services - 6 Hospital Groups and 9 Community Healthcare Organisations. These structures are not aligned geographically and result in separate management and resourcing of acute and community services. This is a clear impediment to moving towards population based planning and integrated care as called for under Sláintecare.

Under Sláintecare proposals, Hospital Groups and CHOs will be replaced with regional bodies which will be responsible for the full spectrum of health and social care services in their region. This will allow care to be planned and delivered at a more local level, based on the needs of local populations.

In July 2019, the Government approved and announced the six geographical areas which proposed regional bodies will serve. The details of these geographical areas are available on the Department's website. Additionally, the Government approved the development by the Department of a detailed policy proposal for the reconfiguration of the HSE supported by a business case, for further consideration byGovernment in 2020.

The detailed proposal will set out the high level organisational design for the system, including: the respective roles, functions, responsibilities and accountabilities of the Department of Health, HSE centre and new regional bodies; the relationship between these entities; and the overall legal construct for the health service. This will provide the framework for systemchange and guide development of legislative proposals and detailed operational planning.

The development of the detailed policy proposals and business case will involve significant engagement with key stakeholders across the health and social care sector, including current CHO and HG management structures, to ensure that any structural changes do not unduly cause disruption and loss of focus on service delivery and the roll-out of the broader reform programme. I would also like to reassure you that the new policy proposals will not have any immediate impact on services. Hospital Groups and CHOs currently provide important oversight of services and it is vital that they continue in this role to maintain the provision of safe services across our health and social care services while the design process for the new regions progresses.

This will include continuing to implement service improvements at both Group level and hospital level, as well as important strategies such as, for example, the Cancer and Maternity strategies.


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