David Cullinane (Waterford, Sinn Fein)
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1106. To ask the Minister for Health the additional responsibilities and roles taken on or assigned to consultants in public health following the creation of this grade; the number of doctors that have moved into this grade, and the additional responsibilities which came with this new role; the impact of this new post in real terms on work practices; if any analysis has been conducted on the difference which these posts have made, as judged against the initial rationale for introducing these posts; and if he will make a statement on the matter. [44343/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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In Q2 2021, my Department, the Irish Medical Organisation and the Health Service Executive reached agreement on implementation of a fundamentally reformed and strengthened model for public health service delivery in Ireland, in line with international best practice and the recommendations set out in a report prepared by Crowe Horwath. To enable the delivery of this model, the agreement included the establishment of 84 Consultant in Public Health Medicine posts through open recruitment on a phased basis ( 3 phases ), with subsequent phases contingent on the completion of a review process, completed in February 2022 and February 2023, demonstrating clear evidence that the desired outcomes were being delivered.

The HSE is currently in the third and final phase of recruitment, having recruited 72 out of the 84 positions with the remainder in various stages of the process, in line with the HSE Pay and Numbers Strategy.

Prior to the introduction of Consultants in Public Health Medicine, work primarily focused on Health Protection, including infectious disease control, as well as the investigation and the management of environment and health issues. Public Health reform has introduced specific posts for the pillars of Health Service Improvement, Health Improvement, Health Intelligence and Child Health. Additionally, Consultants are now embedded in Cancer Control, the National Screening Service, Quality and Patient Safety and Global Health.

The following have already been led and delivered by these new consultant roles, which would be additional to roles and responsibilities prior to the introduction of the new Consultant roles:

1. Established all cross-domain leadership and governance structures, with the appointment of a National Director of Public Health, five National leads and six Area Directors of Public Health, and the mobilisation of National Public Health Senior Leadership and Management Teams.
2. Structural reconfiguration of Public Health from the former Health Board Structure to six new Public Health Areas aligned to Sláintecare areas, led by Area Directors of Public Health and delivering a Consultant-led Public Health service in line with the Hub-and-Spoke model.
3. Progressed detailed specification of requirements, completed market soundings and received official Permission to Tender from the Digital Governance Oversight Unit to support the procurement of an Outbreak Case and Incident Management IT System, a key enabler of a National Health Protection Service.
4. Via the introduction of additional resources, Consultants have led and implemented enhancements to existing infectious disease surveillance systems in the Health Protection Surveillance Centre (HPSC). This will ensure effective monitoring and signalling of what is happening at population level, leading to a greater understanding of disease transmission and severity along with population immunity and risk.
5. Engaged key stakeholders in Public Health, the wider Health Service and an International Subject Matter Expert to define key functions of the new domains of practice at National and Area level within Public Health i.e., Health Protection, Health Intelligence, Health Improvement and Health Service Improvement in line with international best practice.
6. Developed a Health Protection Strategy 2022–2027 led by the National Clinical Director of Health Protection and published in October 2022. Two annual reports inclusive of what has been achieved have also been published.
7. Developed a National Immunisation Office Strategy 2024 – 2027
8. Delivered enhanced multidisciplinary teams, in line with the HSE pay and numbers strategy
9. Delivered first phase Regional Population Profiles with a national comparative report.
10. Delivered a Health Needs Assessment Framework
11. Developed a National Tuberculosis Strategy

1. Children and parents: Provide support to children, parents and child healthcare providers through the Child Health Public Health function and the National Healthy Childhood Programme, commence development of a Child Health Public Health strategy and expand the HSE Newborn Bloodspot Screening Programme.
2. Immunisation: Deliver a high-level of prevention and control of vaccine preventable diseases, including COVID-19 and seasonal flu vaccinations and through the Primary Childhood Immunisation Schedule
3. Health protection: Deliver the HSE Health Protection Strategy 2022-2027 including:
4. • Preparing for and responding to public health threats and major incidents
5. • Ensuring consistent, high-quality public health approaches to prevention, investigation, surveillance, and response to notifiable infectious diseases
6. • Enhancing preparation for new emergent global health threats
7. Information and management systems: Advance first phase implementation of the Outbreak Case and Incident Management System and procure implementation and support services for the development of a National Immunisation Information System
8. New strategy and programmes: Develop a new Public Health Strategy and a new population-based planning approach. Build capacity and capability across the system including for research and partnership (with a focus on health inequalities) and commence delivery of a programme of heath intelligence products and services (including Health Atlas Ireland).

As the HSE continues towards the full implementation of the new consultant model, further monitoring and evaluation of the impact of the new consultants in Public Health Medicine will occur against the implementation of the service plans and over the longer term by the impact of the population health approach on the health outcomes of the population.