Simon Harris Sam Boal / Rollingnews.ie Sam Boal / Rollingnews.ie / Rollingnews.ie

Updated 12.50pm

MINISTER FOR HEALTH Simon Harris has said that in his plan for the health service the HSE will eventually be dismantled and replaced with a “much leaner” national health agency.

Addressing the Oireachtas Committee on the future of Healthcare this morning, Harris said he wanted to share his own “strategic perspective” and the “key priorities I believe need to underpin the future direction of the health service”.

Harris said that once statutory responsibilities and accountabilities are devolved from the centre to hospital and community health organisations, he will “dismantle” the HSE.

Before that happens, the Minister said he will “reform the existing legislation within which the HSE operates to improve governance”.

Harris, in addressing the committee (which was set up under the most recent programme for government), outlined an eight-point plan for the future of healthcare in Ireland as he sees it.

He stressed that in dealing with needed changes within the health services in Ireland, people are suffering from a certain amount of “reform fatigue”.

“Over the next decade we need to get past the stage of constant fire-fighting to a place where we can have a mature debate about how to set priorities and where to develop our services,” he said in his opening address to the committee. “Health  inequality is a major issue, and will become even more marked in the years ahead, unless we find ways to serve all of our people better,” he added.

Failure to recruit

Responding to the Minister’s plan, the Irish Medical Organisation (IMO) criticised Harris’ not mentioning a “need for increased investment” in health services here.

Chairman of the IMO’s consultant committee Peadar Gilligan said that the “inability to recruit consultants to work in Irish public hospitals is a key failure of the health services”.

“The Minister spoke of many issues in his remarks but not on the issue of resources.  We firmly believe that the resources issue is the key issue behind all the challenges facing the health services,” Gilligan said this afternoon.

The simple fact is that there has been for many years insufficient funding, too few beds and the inability to implement a consultant delivered service given the chronic shortfall in consultant manpower.

Impact trade union meanwhile has backed the Minister’s plan, saying it could “support many of the proposals” he put forward.

“I fully agree that structural reforms, and the development of services, must be planned over a ten-year time frame,” national secretary Eamonn Donnelly said.

In our submission to the Oireachtas Committee, Impact and other Ictu health unions proposed that the HSE be replaced with four well-resourced regional health authorities, which would have responsibility for all community and hospital services in their area.

“This is very close to what the Minister said at the Committee today.”

The committee on the future of healthcare has already produced two interim reports, and is expected to publish its final report with cross-party conclusions and recommendations by 28 April.

The HSE has had to contend with many scandals in recent times, from the annual trolley-crisis seen in emergency departments across the country, to the issues surrounding the case of Grace, a woman with disabilities who was left in an allegedly abusive foster home for 20 years after allegations of abuse were first brought to the authorities’ attention.

Harris’ eight-point plan for the health service is:

• Shift Ireland’s model of healthcare towards more comprehensive and accessible primary care
• Increase health service capacity, in the form of physical infrastructure and staffing, to address unmet need and future demographic requirements
• Exploit the full potential of integrated care programmes and eHealth to achieve service integration around the needs of patients across primary, community and acute care
• Strengthen incentives for providers to effectively respond to unmet health care needs by ramping up activity-based funding
• Empower the voice of the clinician and provide them with opportunities to contribute to the management of our health services
• Further develop hospital groups and community health organisations, align them geographically and, as they develop, devolve greater decision-making and accountability
• Follow this with the provision of a statutory basis for hospital and community health organisations, operating as integrated delivery systems within defined geographic areas
• Once statutory responsibilities and accountabilities are devolved from the centre to hospital and community health organisations, dismantle the HSE and replace it with a much leaner national health agency. In the interim, reform the existing legislation within which the HSE operates to improve governance

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