Harney publishes radical health reforms

Far-reaching legislation abolishing the health boards and governing the running of the health service from January 1st next was…

Far-reaching legislation abolishing the health boards and governing the running of the health service from January 1st next was published by the Tánaiste and Minister for Health, Ms Harney, last night. Dr Muiris Houston, Medical Correspondent, reports

It sets out sweeping changes, including a new management structure for the entire public health system.

However, the reforms have yet to be agreed with unions and staff. IMPACT, the health service trade union, yesterday adopted a policy of non-co-operation with the HSE and voted for industrial action in protest at the changes.

In a significant move, the accounting officer for the health service will be the new chief executive of the Health Service Executive (HSE) and not the secretary-general of the Department of Health.

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The Health Bill 2004 will, subject to Oireachtas approval, abolish the Eastern Regional Health Authority and the other health boards and provide for the formal establishment of the Health Service Executive (HSE).

The new executive will be responsible for the day-to-day running of the health service, a function hitherto carried out by the Department of Health. The Minister for Health retains political responsibility for the health service.

Publication of the Bill comes at the end of a week in which the CEO-designate of the HSE, Prof Aidan Halligan, indicated that he would not be taking up the post.

The interim HSE is due to meet today to consider the appointment of an acting CEO.

As well as taking over the function of the State's 13 health boards, the legislation specifies that the HSE will assume the functions of the General Medical (Payments) Board, the Health Service Employers Agency and the interim Health Service Executive. It also provides for the future incorporation of other health service agencies into the HSE.

In a development which will strengthen governance and accountability in the health system, the Bill provides for a statutory framework to deal with complaints from patients and their families. It also establishes structures for public representation and participation by those using the health service.

The HSE will be expected to submit regular reports to the Minister for Health in relation to its performance. It will have to prepare a three-year corporate plan, specifying the key objectives of the HSE, and provide annual progress reports on the implementation of the corporate plan.

The HSE will have an 11-member board, appointed by the Minister for Health: 10 full members and the CEO. Up to four regional health forums, comprising members of city and county councils, will be set up to enable local public representatives to convey their views to the HSE. The legislation also provides for the establishment of local advisory panels to allow communities and patient groups to formally interact with the new executive.

Ms Harney said that the basis of the legislation was to modernise the management structures in the health service. "It is designed to achieve a health service that places the patient at the centre and to ensure that all patients receive the same high quality service, based on need," she explained.