HSE to be dismantled and hospitals run by new trusts

The Government is planning to "dismantle" the HSE which will in time evolve into a new Health Commission. Under the new programme for government, expected to be published this week, hospital services will in future be run by statutory trusts which own their assets and manage the recruitment of staff.

The existing hospital groups, which will evolve into trusts, will have to agree annual performance targets for waiting times, out-patients and emergency department attendances which will be linked to new activity-based funding.

Performance management

It is envisaged that a new performance management unit with its own ring-fenced budget will be established initially within the HSE and later in the Health Commission.

This new body will supply hospitals and other service providers with expert assistance and targeted financial investment to allow them to meet targets.

However hospitals or service providers who do not engage with the new performance management unit and who do not meet their targets, will forego the additional investment funding on offer and will have to use their own budgets to ensure their targets were met “with the assistance of private sector providers”.

Government sources yesterday disputed that private sector companies could take over the running of hospitals that were not meeting their targets.

However one draft of the programme for government says: “We will provide for the temporary transfer of management of hospitals to another provider where there are consistently poor outcomes, patient experiences and financial management.”

Under the Government plans all hospital managers and chief executives would have to be educated to MBA level.

Roles reviewed

New contracts will also be negotiated with GPs and consultants under the proposals while the roles and responsibilities of health professionals will be reviewed “providing extended scope of practice where applicable”.

This will look at transferring to nurses more of the work carried out by doctors and increase the scope of radiographers and radiation therapists to order and report on scans.

In a major departure from the current arrangement where family doctors work for the State as contractors, the new plans will mandate the HSE to employ salaried GPs along with support staff where needed.

The plans also call for a new national bed capacity review to be undertaken before the review next year of the Government’s capital programme.

The Government’s healthcare plans also involve the provision of a special fund of €50 million to improve waiting times for treatments in hospitals.