David Cullinane (Waterford, Sinn Fein)
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244. To ask the Minister for Health the progress made in the HSE directorate becoming a more strategic national centre; and if he will make a statement on the matter. [17838/20]

David Cullinane (Waterford, Sinn Fein)
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247. To ask the Minister for Health the progress made in establishing HSE regional bodies; and if he will make a statement on the matter. [17841/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 244 and 247 together.

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, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.

The new Programme for Government, Our Shared Future, recommits to this core Sláintecare recommendation, stating “Enhanced governance and accountability in the health service is a key component of Sláintecare reform. The HSE Board is now in place and we must now bring forward detailed proposals on the six new regional health areas to deliver services for patients locally that are safe, high quality and fairly distributed.”

As agreed, when the new Regional Health Areas geographies were announced last summer, a business plan for the establishment of these health areas was expected to be brought to Government for its approval in 2020.

The intention was that this plan would set out the high-level organisational design for the health system, including: the respective roles, functions, responsibilities and accountabilities of the Department of Health, HSE centre and new regional structures; the relationship between these entities; and the overall legal construct. These proposals should also outline a timeline for the establishment of regional organisations and for any legislative changes required to realise the Sláintecare vision.

Work was underway in my Department and within the HSE to develop these detailed proposals on Regional Health Areas and the HSE “national centre” but understandably this work was paused as a result of COVID-19. This programme of work will be given further consideration in the coming weeks to take account of the Programme for Government commitment and any new considerations relating to COVID-19.

As part of the HSE's work on this, it is now reviewing the HSE Corporate Centre with a view to providing recommendations on a more strategic national centre which will have greater clarity of role and can better complement and support the health services and regions going forward. These changes will also enable greater decision-making to happen at the front line.

It will be important that there is significant engagement with all key stakeholders across the health and social care sector to ensure that any structural changes do not unduly cause disruption and loss of focus on service delivery. This will be even more important now given the challenges facing the health service as a result of COVID-19.

David Cullinane (Waterford, Sinn Fein)
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245. To ask the Minister for Health the number of HSE national directors that have been relocated to other roles in each of the years 2017 to 2019 and to date in 2020; and if he will make a statement on the matter. [17839/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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I have asked the HSE to respond directly to the Deputy on this matter.

David Cullinane (Waterford, Sinn Fein)
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246. To ask the Minister for Health the progress made in aligning hospital groups and community health organisations; the timelines for delivering same; the processes that will deliver alignment; and if he will make a statement on the matter. [17840/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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Following the announcement by the outgoing Government in July 2019 of the geographies for six new regional health areas, a joint action programme co-sponsored by the HSE, the Department of Health and the Sláintecare Programme Implementation Office was initiated to commence work on the reconfiguration of the health service and development of Regional Health Areas. A draft programme plan was considered by the programme sponsors in early 2020, prior to the onset of the COVID-19 emergency. In April 2020, recognising the need for a robust programme plan to support a reform of this scale, the Sláintecare Programme Implementation Office engaged contractors to work with Sláintecare, HSE and DOH to validate (insofar as possible) the draft programme plan for the service reconfiguration and development of the Regional Health Areas and develop recommendations to enhance the plan based upon international learnings and insights. This work was overseen by the programme sponsors and was completed in May. This report, including the enhanced programme plan, is being considered and finalised. As agreed, when the new Regional Health Areas geographies were announced last summer, a business plan for the establishment of these health areas is expected to be brought to Government for its approval. The intention was that this plan 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 structures; the relationship between these entities; and the overall legal construct. These proposals should also outline a timeline for the establishment of regional organisations and for any legislative changes required to realise the Sláintecare vision. Preliminary work on establishing a process to develop detailed proposals has been undertaken but this work was paused as a result of COVID-19. This programme of work will be given further consideration in the coming weeks in consultation with the Minister to take account of the Programme for Government commitment and any new considerations relating to COVID-19.

David Cullinane (Waterford, Sinn Fein)
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248. To ask the Minister for Health if the HSE has developed and utilised a geographic resource allocation model to ensure equitable allocation of healthcare resources; and if he will make a statement on the matter. [17842/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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Central to improving population health and reducing inequalities is the ability to estimate a populations’ health needs and use this information to design, deliver and evaluate services that meet those needs, within the resources available. One policy measure used to address observed differences between population profiles and promote equitable distribution of available funding is population-based (needs-based) resource allocation. Often referred to as population-based funding formulas, the aim of these frameworks is to adjust capitation funding across the population according to variation in need and the cost of providing required services and supports.

Policy makers are considering the options for implementing population-based resource allocation in Ireland. A review is currently being conducted by the Centre for Health Policy and Management, Trinity College Dublin that aims to inform Irish health care policy by describing models of population-based resource allocation and synthesising evidence about their implementation and impact. Three questions are addressed as part of this review:

1. What are the key concepts and methodological approaches related to population-based resource allocation?

2. How are population-based resource allocation policies specified and realised?

3. What is known about the implementation or impact of population-based resource allocation policies?

This review is expected to be finalised in the coming months.

The HSE 2020 National Service Plan specifies:

Work with the National Health Intelligence Unit to support population health planning and needs assessment in the context of the new regional health areas to develop capacity to support health and well-being services to deliver on health and wellbeing priorities (Health Service Executive 2019)

This work by the HSE had been put on hold during the Covid-19 pandemic.