This weekend will see the dawn of a new era in the health service when the day to day running of services will be handed over by the Department of Health and health boards to a new body called the Health Service Executive (HSE), writes Eithne Donnellan, Health Correspondent
The HSE will have four regional offices and a headquarters in Naas. Its acting head is former managing director of AIB Bank Kevin Kelly who describes the shake up as the biggest change process ever undertaken by the State. The changes take effect on New Year's Day. However, he has said there will be "no big bang".
Neither health board staff nor patients will notice much change for several months. There are to be no redundancies and health board CEOs have been asked to stay on for another six months to manage services at local and regional level. They will report to the HSE and assist, it is hoped, with a "smooth transition" process.
How smooth things go, however, will be largely dependant on the co-operation of staff. The IMPACT trade union, which represents some 25,000 health workers, began industrial action on December 13th. It wants guarantees on jobs and working conditions.
Notwithstanding their action the changes are going ahead, the Tánaiste and Minister for Health Ms Harney has insisted. She claims the new structures will put patients first. Opposition parties are not so sure. Labour's health spokeswoman Ms Liz McManus said she can't understand why the legislation underpinning the changes had to be so rushed given how little things will change on January 1st. She also fears levels of accountability will be minimal as the HSE will meet in private. Fine Gael's health spokesman Dr Liam Twomey is also concerned about accountability. He said health boards would only be "technically gone" as they would still all have directors of finance and other services for the moment. A voluntary redundancy package should have been offered, he feels.