Radical proposals to reform the structure of the State's health system, reported exclusively in yesterday's Irish Times, represent an opportunity to reverse the chronic decline in the public health service. In a week which saw the now annual outcry concerning overcrowding in hospital accident and emergency departments, the reforms suggested by Prospectus management consultants are timely. They represent a further stage in the implementation of the 2001 National Health Strategy.
It has been clear for some time that the health board structure, first introduced over 30 years ago in the 1970 Health Act, is in need of reform. Recent problems within the North Eastern Health Board and the current crisis in accident and emergency services underline that need. The failure of services to improve for patients, despite the injection of considerable amounts of money into the health service, is the strongest signal of all that reform is overdue.
By replacing the present structure with a national health service executive and four regional executive bodies, the influence of local political representatives will diminish - assuming these proposals are accepted by the Government. Instead, there will be greater professional and consumer representation. The Department of Health itself will be radically altered; a much leaner structure, its remit will be to focus on strategy development and policy making. A national hospitals' agency will take responsibility for all hospitals in the Republic, including the hitherto independent voluntary hospital sector.
Together with the long-awaited report of the Medical Manpower Task Force and the deliberations of the Commission on Health Funding, the Prospectus Report completes a package which will create a new structure for a reinvigorated health system. However, such large scale reform will not be achieved quickly or easily. It will take considerable time to draft a new health act. A rearguard action by vested interests keen to retain the staus quo is inevitable.
It is those at the top of the health board executive structure, as well as local politicians, who are most likely to resist change. But the early positive response of patient representative groups and of health care professionals indicates that change may not be significantly blocked. The potential benefits of these proposals for patients are significant. Not alone will services be delivered in a more efficient and streamlined manner, but patients, as consumers, will have a real voice in the planning and delivery of health needs.
The Minister for Health, Mr Martin, must now demonstrate the political courage to deliver on these proposals. He can set in motion a process which should lead to a fairer and more equitable public health service for all. It will take some years for the benefits to be felt and for the Minister to receive the credit he will then deserve.