Harney cites efficiencies in defence of HSE changes

MINISTER FOR Health Mary Harney said the planned changes in the Health Service Executive (HSE) were aimed at bringing about more effective organisational structure and better patient care.

She denied the move represented a U-turn by the Government on its decision in 2004 to abolished local health boards and establish the centralised HSE.

However, Fine Gael said the proposed move to revert to a devolved regional structure for delivering healthcare represented an admission of failure.

The party’s health spokesman, Dr James Reilly, said the fact that new HSE structural changes were being introduced showed the Fianna Fáil/PD administration had botched the health reform process in the first place.

Speaking on RTÉ radio yesterday, Ms Harney said she believed the unified health service administration system under the HSE was working.

She said that, in its absence, it would not have been possible to introduce the new cancer care reforms or consistent standards for nursing homes which applied around the country.

The Fitzgerald report, published earlier this year on the cancer controversy in Portlaoise, had identified deficiencies in organisational structures, she said – such as staff being confused as to their areas of responsibilities.

“We want to make sure that the appropriate organisation structures are in place. We want to see policymaking and standard-setting carried out at national level with implementation at local level.”

Dr Reilly said that when she launched the Bill establishing the HSE in November 2004, Ms Harney had described it as a “historic piece of legislation”.

He said she had also maintained that it would provide for “the most comprehensive reorganisation of our health services since 1970”.

“If it is the case that there are plans to revert to devolved regional managers, Health Minister Mary Harney is now accepting that the HSE she designed, the structure she created, is not working,” he said.

“Having resolutely defended the HSE in the face of repeated warnings, it would appear that Minister Harney and her Cabinet colleagues are now saying the HSE needs 1,000 less staff in a more devolved structure.”

Dr Reilly said he had long been arguing that “we need a HSE where decision-making on services is devolved to regional and local level to the greatest extent possible”.

He said the proposals under consideration showed that the message was sinking in but that the reforms had to be carried out in the context of overall reduced bureaucracy, along with improved accountability and complete clarity on roles within the HSE.