‘Radical HSE reform’ will see nation split into regional zones
IRELAND is to see ‘radical reform’ of the health sector, after Cabinet approved plans to split the service into regional divisions.
Health Minister Simon Harris confirmed that Cabinet gave the go-ahead for the six new regional health bodies at a meeting yesterday morning, before a formal announcement in the afternoon.
The health bodies are to deliver ‘people-centred’ health and social care, with their own budget based on local population needs, deprivation factors, age and other factors based on residents.
The goal of the plan is that the majority of care will be delivered in the community and not in acute hospitals.
The proposed regions will be based on population data, averaging at around 50,000 people, lettered Area A through to Area F, however patients may choose to be treated elsewhere.
While the HSE will continue to be the central executive with responsibility for planning and strategy, regions will have greater autonomy at local level, including budget allocation, a move the minister said would ‘improve accountability and transparency’.
Mr Harris spoke about ‘radical reform in the delivery of healthcare’, ‘a new direction’ and that ‘the HSE as currently constructed will not continue’.
He criticised opposition leader Micheál Martin’s former tenure as health minister, saying the HSE in how it was set up and as it stands ‘is not workable’.
Both the minister and HSE CEO Paul Reid said there won’t be more managers, but a more ‘streamlined national centre’ to avoid duplicating personnel.
However, the final structure of the organisations has not yet been decided, and it is not known how many personnel may be lost after services are amalgamated.
In terms of price, ‘there is no cost expected in this initial step of the process’, the Government statement said, yet later added: ‘The establishment of new regional bodies will require an organisational change programme which will require investment.’
Mr Harris said: ‘This will result in clear financial and performance accountability, empower frontline staff and devolve authority from the HSE to the local regions.’
The new health areas are in line with recommendations made in the Oireachtas Committee on the Future of Healthcare Sláintecare Report (2017), that regional bodies should be responsible for the planning and delivery of integrated health and social services.
Stakeholders in each of the areas will be invited to contribute to the design of the services.
Work will also now be undertaken to detail the national and regional organisational design which will be brought back to Government for approval within 12 months. The regions and their budgets come into effect in 2021.
Fianna Fáil leader Micheál Martin said: ‘There has been an absence of consultation again. We haven’t been consulted in relation to it. I know there has been poor consultation with stakeholders out there because people have said it to me. They have heard rumours but they haven’t been told.
‘For example, I know Waterford is going into a new hospital grouping now, decisions have
‘HSE as it stands is not workable’ Changes set to ‘empower staff’
been made here in terms of appointments and so on and they now have to be changed, but the people concerned weren’t consulted or at least some of the people weren’t consulted.’
Mr Reid said: ‘By aligning our services geographically, it means health service staff can plan hospital and community services together, and this helps provide more integrated care at both regional and local level.
‘The new health regions will have greater autonomy to plan for, manage and deliver services based on the needs of the people they serve,’ he said.
However, the Irish Hospital Consultants Association voiced concerns yesterday. Association President Dr Donal O’Hanlon said: ‘For this realignment to work effectively all hospital and community health services should be merged, and not just aligned, into one organisation within specific geographic areas.’