Five separate strands of legislation will be drawn up over 18 months by a 30-person group to implement a radical reform package for the Irish health system which will be launched today. Arthur Beesley, Political Reporter, reports.
Government backbenchers will be briefed this morning on the biggest revamp of the health service in more than 30 years. The briefings to TDs and Senators in Fianna Fáil and the PDs will be among the first acts of a major Government publicity programme to seek support for the far-reaching measures.
The Government said last night it was moving ahead with the initiative after a joint proposal by the Ministers for Health and Finance was endorsed without objections at a Cabinet meeting yesterday morning. After enduring political flak for months over health cutbacks, the Government will present the initiative as an ambitious and radical plan of action to reform the health system.
The Taoiseach, Mr Ahern, gave an implicit confirmation last night that the 11 health boards will be abolished under the plan when he said that "politics, including local politics, has to stop at the door of our hospitals". The Tánaiste, Ms Harney, described the initiative as "the most far-reaching package of reforms in a generation to our public health service".
Mr Ahern and Ms Harney were speaking in a Dáil debate in which the Labour leader, Mr Pat Rabbitte, said the change would make the system "even less accountable, more remote, and probably more expensive". The Fine Gael health spokeswoman, Ms Olivia Mitchell, had earlier dismissed the plan as a decoy to deflect attention from the immediate crisis. The plan would not produce a single extra bed, she said.
Early signals of resistance to the initiative emerged yesterday when it was the disclosed that the Eastern Regional Health Authority had sought legal advice on its proposed dissolution.
In addition, two individuals who attended a briefing for health managers by the Minister for Health, Mr Martin, expressed unhappiness with the level of information they received.
The three-year initiative will shift day-to-day control of the health system away from the Government and local politicians.
While it will require detailed negotiation with health staff, unions in the sector signed up to the principle of reform in the new social partnership agreement.
The plan is based on a report on health funding by Prof Niamh Brennan of UCD and another on structures by the consultancies Prospecture and Watson Wyatt.
But crucial details will not be finalised until the Government considers a separate report on medical manpower by the Hanley review group. These include a proposal to give medical consultants responsibility for their budgets. The role of the Department of Health will be stripped back significantly, to concentrate on policy. Some 32 of the 58 existing State health agencies will also be abolished.
While the Department will fight for the health budget in the Estimates process, the money will be allocated by a new Health Services Executive which will have statutory responsibility for the delivery of all services. The chief executive of the body will be answerable to a board of directors and a Government-appointed chairman.
It is believed that places on its board will be reserved for officials from the Department of Finance. This reflects the repeated concern of the Minister for Finance, Mr McCreevy, about the management of health expenditure.
The Health Services Executive will control acute hospitals through a new National Hospitals Office. It will control non-acute services through four regional health agencies, which will replace the 11 health boards.
The Government is also likely to face resistance from local politicians who will lose their seats on the health boards.