Wednesday, 18 November 2020
Department of Health
206. To ask the Minister for Health the current resource allocation system in use to ensure health resources are allocated fairly and in proportion to need; and if he will make a statement on the matter. [37361/20]
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 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. Work was underway in the Department of Health and the HSE to develop these detailed proposals, in consultation with stakeholders. Understandably, this work was paused as a result of COVID-19. This programme of work will be given further consideration to take account of the Programme for Government commitment and any new considerations relating to COVID-19.
The programme plan to support the development of the Regional Health Areas included a focus on the development of resource allocation modelling on the basis of population needs assessment. One of the goals of the regional devolvement of health services is the concept of “one region, one budget”. A key factor in implementing this goal will be determining the methodology and approach to the allocation of resources, on a population basis which takes account of need. Clearly, the way in which resources are allocated will be determined by the nature of services provided at national, regional and supraregional level, as well as the governance that determines the flow of resources. It is critical that the approach to resource allocation is equitable, quality-driven, responsive to population health needs, outcomes focussed and sets up regions to deliver best outcomes for available resources. This will be a significant undertaking but one that is critical to the reorganisation of the health and social care service and the operation of regional structures. The initial focus of this work will be on conducting an “as is” mapping of current resource allocation, learning from international approaches, feasibility and readiness assessment and stakeholder engagement. This will inform and enable work to then commence on specification of a geographic resource allocation formula.