Thursday 18 January 2018

How the health services will change

• THE Health Service Executive (HSE) structure will remain unchanged until the new legislation is passed at the end of the year.

• When the legislation is passed, there will be a top- tier overhaul, with the existing posts of chief executive and 10 directors abolished.

• They will be replaced by a director general and six directors. All will be newly recruited but may include executives who currently hold some of the existing posts.

• The board of the HSE will be abolished.

• The HSE -- which was responsible for day-to-day running of the service -- will be less powerful and the Department of Health will recover control and dominance it lost in 2005.

• Individual sections of the HSE, such as primary care and mental health, will have separate budgets. The aim is to get more evidence of where they money is spent.

• The secretary general of the Department of Health will take back legal accountability for the health budget from January. This is currently in the hands of the HSE chief executive. When this was transferred to the HSE in 2005 it was billed as ending political influence in health spending. With more ministerial power over finances, the jury is out on what temptations this reversal of power would have for a shaky government.

• The HSE will end in 2014 and be replaced by an integrated care agency, which will become a purchaser and provider of healthcare.

• Other functions will go back to the Department of Health.

• Hospitals will form networks next year.

• Nobody who is permanent and pensionable will lose their job.

Irish Independent

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