The Tánaiste, Ms Harney, has said her main focus during her term as Minister for Health is to sort out accident and emergency services and to deliver on extensive health service reform.
Central elements to reform will be a new "flexible" contract with hospital consultants and a greater role for private - "independent" - healthcare in the provision of primary/GP and hospital services, she said in her first major newspaper interview since taking up the post.
Ms Harney reaffirmed her intention to radically improve A&E services, which has been signalled by the appointment of Angela Fitzgerald to the National Hospitals Office to oversee implementation of the Minister's 10-point plan to improve hospital A&E departments.
Ms Fitzgerald, who was director of planning and commissioning with the Eastern Regional Health Authority, took up her post on January 1st. "I am pleased there will now be a single person responsible for the implementation of the package," Ms Harney said.
Announced as part of the Budget Estimates for 2005, the €70 million A&E initiative includes the promise of more out-of-hours GP services; the development and expansion of minor injury units and chest pain clinics; three new acute medical assessments units at Tallaght, St Vincent's and Beaumont hospitals in Dublin; and measures to enhance direct access for GPs to diagnostic services.
In the interview with The Irish Times Health Supplement, Ms Harney said she finds the Minister for Health's job more interesting than she had anticipated.
The Tánaiste said it was in her view important to stay focused on solutions and to avoid being reactive or adopting a fire brigade role. "I am keen not to get involved in individual patient cases."
Asked about the decision by Prof Aidan Halligan - the Irish doctor who is deputy chief medical officer of the Department of Health and director of clinical governance with the NHS in Britain - not to take up the post as chief executive of the new Health Service Executive (HSE), Ms Harney acknowledged it was a setback, "but not a fatal blow to the reform process".
She said she was hopeful a replacement would be found by the end of March, although she admitted that someone with the necessary mix of skills for the post "would not be an easy person to find".
New legislation to facilitate the establishment of the HSE identified clear lines of responsibility, she noted. "I am very anxious that the HSE has a strong accountability role to the Oireachtas." .
It was her intention that the HSE set up a Parliamentary Affairs Division, "so that members of the Oireachtas are responded to quickly and effectively" by the HSE.
Ms Harney also signalled she would not allow the current row over who is responsible for the past liabilities of hospital consultants to slow up the reform process.
"I am not going to wait for ever. Patients will get new consultants - that will happen," she said, adding that there was a need for a substantial increase in consultant numbers, "somewhere in the order of 700 to 1,100 (more)".
She said she will appoint management consultants this month to examine whether it would be possible to develop private sector initiatives on the grounds of public hospitals.
"I want to see less private patients treated in public hospitals."
The Tánaiste said she feels strongly about people with cancer not having to travel "hours and hours in a car for treatment". Asked where this left the Hollywood report on radiotherapy, which advocated a centralised model of treatment facilities, she said it should be possible to have both a network of facilities while offering some local treatment.
