Simon Harris to propose major changes to health service structure

The Minister for Health, Simon Harris, is to propose major changes to the structures of the health service and suggest that most healthcare could in future be run by new regional groups.

In the coming days the Minister is expected to outline to an Oireachtas committee his desire to dismantle or radically reduce the Health Service Executive (HSE). The HSE could be left as a small agency to run national programmes dealing, for example, with issues such as cancer.

Mr Harris is also likely to propose that clinical directors should have a greater role in running hospitals in the future.

The Minister is expected to suggest to the Oireachtas committee examining the future of healthcare that there is a need to remove several layers of bureaucracy in the health service.

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At present, hospital services are operated by six regional groups. However, it is understood that the Minister will suggest these could be integrated with existing community health organisations. Such new regional bodies, under the Minister’s proposals, would each have a single management team.

No local politicians

However, while services would be run by regional bodies, there would be no involvement of local politicians, which happened in the former health boards that were abolished to make way for the establishment of the HSE more than a decade ago.

The Minister will ask the Oireachtas committee to examine whether Ireland should appoint one person to oversee the running of the health service. This would be a secretary general in the Department of Health and would remove the need for a director general of the HSE.

On the issue of accountability, Mr Harris will acknowledge the need for strengthened legislation to ensure that those who fail in their duties can be disciplined.

The Oireachtas committee is examining a 10-year strategy for the future of the health service and will complete its report by April.

Meeting with consultants

Meanwhile, the Irish Hospital Consultants Association (IHCA) said it emphasised to the the Minister at a meeting last Thursday the urgent need to overhaul governance of the health service.

IHCA president Dr Tom Ryan said that "accountability and transparency must be improved at all levels of planning and execution in our health service. Our health system must become more responsive to our patients' needs. Current bureaucratic structures and processes are failing to adapt to the needs of the growing number of our patients and are no longer fit for purpose. To prioritise the needs of our patients, there must be a greater emphasis on clinical leadership in all aspects of healthcare."

Dr Ryan said the new 10-year strategy presented a real opportunity to address the critical shortage of hospital beds, support services and frontline staff, in order to provide care for the increased number of our patients arising from our growing and ageing population. He said the strategy must include a blueprint outlining an increased capacity and a yearly commissioning timetable.

“Anything less than this means that the strategy will be seen as a fudge that could set healthcare back for decades,” he said.