HSE back to health boards
U-turn means local bodies will replace failed centralised approach
Wednesday September 16 2009
THE Health Service Executive (HSE) is on the brink of a new shake-up with the creation of four "mini" health boards.
The move will see more decision-making and financial authority devolved to the regions -- marking a major U-turn from the centralised regime which has been at the heart of the HSE since it was set up in 2005.
Four regional directors are being appointed, who will head their own teams, and have full accountability and responsibility for services in their area.
Oversee
They will report back to HSE headquarters, which is creating a new Integrated Services Directorate to oversee hospitals and community services in the regions.
Laverne McGuinness, who will jointly head the new national directorate, said each regional director would have to enter into "performance contracts".
They will be required to meet targets under this contract or else have some of their authority over funding withdrawn.
The HSE was set up in 2005 when the old health boards were dissolved after they were seen as too parochial, operating as fiefdoms to the detriment of a streamlined linked-up approach.
They were accused of failing to bring any uniform order to how the health service was managed, and were seen as obstacle to the reorganisation of hospitals.
Instead, two national offices -- separately overseeing hospitals and community services -- were established.
The promise was that the new centralised approach would benefit the public.
Now they are to be merged again under the new national directorate in a bid to end the divide between hospitals and community services.
Nearly five years on the HSE admitted it now needs to bring decision making closer to the point of where the service is delivered.
The directorate is expected to be jointly run by Ms McGuinness and Ann Doherty whose directorates will be joined up -- both will retain the same salary.
Unlike the old health boards, there will be no board of elected and nominated members, who were accused of being too inward looking, rejecting decisions which could lead to a hospital losing a service.
The new regional teams are expected to be up and running by next January.
A spokeswoman for the HSE said yesterday the agency was working through the appointment of the regional directors through the Public Appointments Commission and could not say what salary they would be on. The entire shake-up must be "budget neutral", she added.
Spread
Ms McGuinness said up to now responsibility at regional level had been spread between various executives but now one person would be accountable.
Under the contracts the regional directors will be required to deliver a particular level of quality of service as well as ensuring it is safe and efficient.
They will be reviewed monthly and where targets are being missed there will be a "ladder of support".
She said they would be rigorous in their approach to monitoring performance and dealing with risks as they arose.
- Eilish O'Regan, Health Correspondent
