HSE structural reform to be considered by Cabinet

Board restoration and management review to be part of plan to rebuild public confidence

Taoiseach Leo Varadkar: Fianna Fáil has criticised him for his absence throughout the CervicalCheck controversy. Photograph: Gareth Chaney Collins

Taoiseach Leo Varadkar: Fianna Fáil has criticised him for his absence throughout the CervicalCheck controversy. Photograph: Gareth Chaney Collins


The Cabinet will on Tuesday consider major reforms to the governance structure of the Health Service Executive in an attempt to restore public confidence in the organisation.

Minister for Health Simon Harris will seek approval from colleagues to restore the HSE board and to conduct a review of the current management system within the body to assess if it is fit for purpose.

The board will also be asked to develop an effective performance management and accountability system within the HSE.

A spokeswoman for the Minister said he believes the current structure does not provide an adequate governance arrangement for the HSE and measures to strengthen the oversight and performance of the organisation are required.

Under the proposed legislation to be considered by Cabinet, the board will be accountable to the Minister for the performance of its functions.

It will also be responsible for the appointment of a chief executive, who will be responsible to the board for the performance of his or her functions.

As part of its first tasks, members will be asked to prioritise a full examination by the new director general of the current senior management in the HSE – structure, responsibilities, capacity, skills and experience.

Accountability system

It will also oversee the development and implementation of an effective performance-management and accountability system in the HSE within a set time period.

The spokeswoman for Mr Harris said: “This should include measuring performance on service delivery, financial/budgetary management and reform, including culture and behavioural change.”

The last HSE board was abolished by Fine Gael in 2011 under reforms introduced by the then minister for health, James Reilly. However, the recent cross-party committee report, Sláintecare, called for its re-establishment.

The Cabinet will also on Tuesday consider a proposed strategic “national centre” tasked with carrying out national level functions, and with new regional bodies accountable for implementing integrated care.

The proposals follow weeks of controversy over the CervicalCheck controversy and the failure to inform women of the results of a clinical review into their cases.

The Government has already committed to a package of financial measures for those women, and to the possibility of redress following the results of a scoping exercise into the issue.

Failed in duty

However, there have been increasing calls for accountability and in ensuring those who failed in their duties are held to account.

The Oireachtas health committee and the Dáil’s Public Accounts Committee will also hold meetings on the issue this week.

Three memos on what the HSE was told in 2016 about the cancer audits which are now the subject of a non-statutory inquiry were sent to the Public Accounts Committee on Thursday. It is understood a number of other pieces of documentation have been identified within the Department of Health relating to the issue.

However, political sources stressed neither Mr Harris nor Taoiseach Leo Varadkar were aware of any such evidence during their tenure in office.

Meanwhile, Fianna Fáil has criticised Mr Varadkar for his absence throughout this controversy.

The party’s health spokesman Stephen Donnelly said there was “constant coverage” of the Taoiseach during Storm Ophelia “ standing with members of the Defence Forces and the gardaí” but claimed no such situation has happened with the HSE.