New authority, area boards to replace EHB

A new health authority and three area health boards are to replace the Eastern Health Board under a Bill introduced by the Minister for Health, Mr Cowen. The Health (Eastern Regional Health Authority) Bill would enable the delivery of health and personal social services to be brought closer to the people, he said.

"Decisions regarding the provision of local services will be made closer to the point of delivery and, through the involvement of local councillors on each area health board, more involvement by local communities in the planning and organisation of their health services will be made possible."

In the 30-year period between 1966 and 1996, the population in the Eastern Health Board area increased by 41 per cent, 11 per cent of which had occurred since 1981.

The population was expected to increase still further in the next few decades. At present it stood at 1.3 million, compared with the populations of the other health boards, which ranged between 200,000 and 500,000 people.

The size of the board's population, coupled with the fact that most of the acute hospital care in the region was outside its remit, had made it difficult for the Eastern Health Board to achieve a strong sense of identity among the community it served, he said.

There had also been a marked increase in social problems such as drug abuse, child abuse and homelessness. High levels of deprivation occurred in many parts of the region, and substantially heavier demands on health services were predicted for the next century.

Mr Cowen said all service provision within the eastern region - whether the service provider was a statutory body or a voluntary agency - would be on the basis of a written, legally binding service agreement between the authority and the service provider. This would ensure "better planning, better budgeting and more accountability at all levels", he said.

The Labour spokeswoman on health, Ms Liz McManus, warned that if the Bill was passed unamended, it had the potential to shift the balance within the entire health board area in a way that would be at variance with the principles of democratic accountability and transparency.

As well as the establishment of a health board authority, a new executive, unaccountable and unelected, separate from anything to do with the Eastern Health Board, was being introduced. "It serves as an indicator that what we are discussing may not be genuine devolution of power and that the boards may turn out to be puppet regimes rather than centres of governance."