The Irish path from local democracy to centralised administration:
The Health Service Executive (HSE) is "the first ever body charged with managing the health service as a single national entity", in the words of the Minister for Health. Local bodies initially funded by local taxation have administered the service since the foundation of the State.
1960: Minister for Health, Sean MacEntee, warned campaigners for reduced local taxation that if the Exchequer wholly funded health services, the Minister might take them over or entrust "their operation to bodies nominated by him. Personally, I would view such a development with the utmost disfavour, and I think so would most people.
"Nevertheless, if taxation without representation is to be deprecated, so also is local control without local taxation those who wish to maintain democratic control in the local administration of the health services must be prepared as rate-payers to pay for it."
1970: The 1970 Health Act provided for the establishment of eight health boards to administer the health service in place of county councils and urban health authorities. Their elected membership included local councillors and health professionals.
1970s: The health charge on the local rates was phased out giving the boards "local control without local taxation".
1999: The 1999 Health Act provided for the establishment of the Eastern Regional Health Authority and three subsidiary area health boards, bringing to 11 the number of boards.
June 2003: The Government announced the abolition of the health boards and their replacement by a HSE with a board nominated by the Minister, the development which MacEntee had "viewed with utmost disfavour".
A total of 27 agencies would be subsumed by the HSE, by a new health information and quality authority (HIQA) or by a restructured Department of Health.
November 2003: The Government appointed the interim HSE Board.
April 2004: The Health Amendment Bill 2004 was published providing for the abolition of the membership of the health boards and assigning their functions to their chief executive officers. Micheál Martin described this as "very much interim legislation" pending a Bill to provide for the establishment of the HSE. This Bill was likely to provide for the establishment of "a series of regional fora to facilitate local representatives in raising issues of concern" with the new executive.
January 1st, 2005: The target date for the HSE to acquire a statutory footing provided the Dáil has passed the as yet unpublished HSE legislation.