The State's 10 health boards and the Eastern Regional Health Authority are to be abolished and new national agencies established to take over the running of hospitals, primary care and the health structures in the most radical shake-up of the health service in 30 years, writes Olivia Kelly.
Through a series of "modernising" reforms, the Government yesterday promised to create an "accountable, effective and efficient" health service that would be capable of responding to the needs of the public.
Foremost in its rationalisation process, detailed in the Health Service Reform Programme, will be the abolition of the health boards and a reorganisation of the Department of Health to focus on health strategy and policy rather than the day-to-day running of the service. Work previously within the remit of the health boards and the Department will be allocated to a smaller number of new bodies.
The Health Services Executive will be the over-arching body responsible for the day-to-day running of the health service. The executive will work independently of the Department, reporting directly to the Minister. It will have its own board.
The abolition of the health boards will also see a greater level of financial responsibility or "personal accountability" falling to consultants in hospitals and GPs in the primary care sector.
Doctors, along with other health professionals and managers will be held accountable for the "financial implications" of their decisions by the Health Service Executive, which will also have the statutory authority to assign their duties.
Consultants and GPs will be required to renegotiate their contracts to ensure they are made financially responsible for their duties.
The Health Service Executive will have three separate arms: the National Hospitals Office, the Primary, Community and Continuing Care Directorate, and the National Shared Service Centre.
The hospitals' office will be responsible for all acute hospitals in the State, including independent voluntary hospitals. The office will take over the planning and funding of hospital services - including decisions on where to locate hospitals, manage waiting lists and have control of approving consultant posts in public hospitals.
The primary and community care directorate takes responsibility for non-hospital services. These services will be administered through four regional health offices encompassing existing community care structures, such as health centres.
The shared service centre will be created to ensure that, where practicable, services are shared across the health system to ensure a universal standard of care and to save money.
Separate to the health executive will be the Health Information and Quality Authority.
The authority will encompass the National Disease Surveillance Centre, the National Cancer Registration Board and the Irish Health Service Accreditation Board.
Under the reform programme, five professional bodies and councils are being merged.
These are: the Postgraduate Medical and Dental Board, the National Council for the Professional Development of Nursing and Midwifery, the National Social Work and Qualifications Board, the Pre-Hospital Emergency Care Council and the Poisons Council.