THE HEALTH Service Executive (HSE) is to propose changing its current management structure and reverting to a more decentralised system. Under the new proposals, authority for running hospital and community services would be devolved to new regional management structures.
Details of the proposals, which were considered by Government Ministers in recent weeks, will be given to trade unions today. The current centralised system in the HSE for running hospital and community services, it is envisaged, will be broken up. Existing management structures would also be streamlined.
The current system has been strongly criticised by politicians, unions and patient groups for being too bureaucratic, for taking too much power away from local areas and for frequently passing issues up the line to Dublin for decisions.
The proposed reforms represent the second major change to health structures in less than five years. In 2004, the Government abolished the 11 health boards and replaced them with a centralised Health Service Executive.
Under the new plans, regional directors would run hospital and community services in their area and determine how funding provided by the HSE at national level should be allocated. According to informed sources, there could be four or possibly up to eight new administrative regions.
At present, responsibility for acute services is vested in the HSE’s centralised national hospital office. In parallel, a separate national directorate runs primary, continuing and community services nationwide. The HSE proposals would see the top-level management team being streamlined.
It is also proposed that a new national clinical director, most likely a senior consultant, would be appointed, who would work closely with the hospital clinical directors.
The proposed streamlining of the management structures could also feed into current HSE proposals to Government for a voluntary redundancy scheme for up to 1,000 staff, at a cost of €30 million. Minister for Health Mary Harney said last month that no decision on such a redundancy programme would be made until the review of HSE structures was completed.
