ERHA members seeking legal advice

Legal advice is being sought on behalf of members of the Eastern Regional Health Authority on its proposed abolition

Legal advice is being sought on behalf of members of the Eastern Regional Health Authority on its proposed abolition. Eithne Donnellan, Health Correspondent, reports.

News of the move, which was initiated just over a week ago, comes as a report being published today recommends the abolition of the ERHA, along with the abolition of all other 10 health boards. The Government agreed to the changes yesterday.

Mr Christy Burke, a Sinn Féin representative on the ERHA, said last night the legal advice was being sought because members of the authority feared the ERHA would be axed overnight.

They asked their chief executive Mr Michael Lyons to obtain the advice of senior counsel on the Minister's powers in this regard. They wanted to know if he can abolish the authority and how he might go about it.

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Mr Burke said the members also sought a special meeting of the authority to hear details of the planned health service reform package. That meeting is due to take place tonight. "We will probably get the legal advice at the meeting," he said.

The councillor stressed he had no problem with change. "It's overdue and I've no problem with it as long as it's going to be of benefit to the man and woman on the street," he said.

However he has reservations about the dropping of local councillors from health boards. "I have concerns about that. Going back some years ago there was no political representation on the blood bank and look what happened," he said.

While the legal advice sought by the ERHA may be the first tangible sign of resistance to the radical health service reform package, pharmacists and hospital consultants are also lining up to oppose measures proposed in the Prospectus and Brennan reports.

The vice president of the Irish Pharmaceutical Union, Mr Karl Hilton, said that while the IPU supported any initiative to bring down costs it would not allow the health of patients to be compromised. This could occur if patients, unaware that generic drugs were equally effective, failed to take their medication because it looked different, he said.

He added that at the moment 72 per cent of all medicines on State schemes are dispensed on a fee-only basis with pharmacies getting €2.80 for each prescription. "This is totally unrealistic in today's market and we would be looking for increased remuneration for the medical card scheme and under no circumstances will we co-operate with the Department if they try and extend the fee-only basis to other State drug schemes, which is suggested in the Brennan report," he said.

Mr Donal Duffy, assistant general secretary of the Irish Hospital Consultants Association, reiterated that the IHCA would not agree to the proposal that all new consultants treat public patients only.

He said however that the IHCA long held the view that there were far too many health boards in the country and it welcomed plans to abolish them. He said however the single biggest factor affecting the provision of hospital care in the State was the shortage of acute hospital beds.

Brennan Report

This report, which examines value-for-money in the health system has also called for sweeping structural changes. It has proposed:

A new Health Service Executive agency should take over the management of the health service from the Department of Health and tackle what the report describes as a "management vacuum" at the heart of the health system.

The new agency should urgently examine ways of reorganising accident and emergency services and ways of providing alternative accommodation for the long-stay patients who currently occupy 25 per cent of acute hospital beds

Greater financial responsibility be given to GPs and hospital consultants

Budget limits should be negotiated for the medical card scheme and reimbursement of GMS drug costs should be limited to the cheapest medication on the market

The Department of Health should take immediate steps to agree amendments to the common contact of hospital consultants and set out consultants' duties in planning and controlling the resources allocated to them

It proposes a cap on the number of private patients treated in public hospitals as well as the setting of core times when a consultant must be available to patients in public hospitals

All new hospital consultant appointments should be made on the basis of a contract to work exclusively in the public health sector.

Prospectus Report

This audit of health structures will recommend that:

Health boards be abolished and replaced with four regional executive bodies

The executive bodies should have greater professional and consumer representation at the expense of local political representatives

A new national hospitals' agency should take responsibility for all hospitals in the Republic, including the independent voluntary hospitals

A new Health Service Executive be responsible for the day-to-day running of the health service

The Department of Health should focus exclusively on strategy development and policy making rather than on day-to-day running of the health service.