Two Fianna Fáil backbenchers have expressed concern that the new Health Service Executive (HSE) will be just another layer of bureaucracy in the health service.
The comments from Ms Beverley Cooper Flynn and Dr Dermot Fitzpatrick yesterday came a day after the Minister for Health, Mr Martin, announced the composition of the board of the new interim HSE. The structure will take over the day-to-day management of the health service from the Department of Health.
"I'm worried about this HSE," Dr Fitzpatrick told the joint Oireachtas Committee on Health and Children. "Are we going to put in another layer of bureaucracy that is going to get in the way of the patient and their treatment?"
Ms Cooper Flynn added: "I too am concerned". She wondered who would run the HSE and if they would be the same people who were currently running the health service.
The questions were directed at Prof Niamh Brennan, a member of the board of the new interim HSE and the UCD economist who chaired an audit of financial management in the health service that reported in June.
Her report, known as the Brennan report, recommended the setting up of the HSE.
Prof Brennan said it was not her intention that the new HSE would be another layer of bureaucracy. She said the system needed a head office to take control. She felt sure it would deliver the accountability the system required.
Meanwhile, Prof Brennan told the committee it had not been her intention to offend people working in the health service when she documented in her report the many problems in the service.
Points about poor planning, salary overpayments and such things as the fact that a health board paid over a cheque for €444,408 for land in Ballinamore without title being cleared, and the fact that a hospital was unable to bill the VHI/BUPA for more than €1 million in private patient charges because hospital consultants had not supplied the necessary information in respect of their patients, were made to create a compelling case to change the system, she said.
"Many of the problems arise not because people have made mistakes but because of fundamental structural weaknesses in the system."
Furthermore, she said, the issue of overpayments to GPs over so-called ghost patients was not the fault of doctors. "They did not cause the problem. They are not responsible for the problem. It was a management problem," she said. However, she reiterated a point she made before that if there was evidence GPs had been overpaid, then they owed the money back.
Senator Mary Henry said she knew a GP who informed her health board some time ago that two of her medical card patients had died, yet she recently got a letter from the board asking her to ensure these patients got the flu vaccine.
Prof Brennan said there had been "a piecemeal, selective" approach to some reports in the past but she believed "cherrypicking" from her report, rather than implementing it all, would not solve the problems it set out to resolve.