Press Release

Another key step to a better health service

The Minister for Health Dr James Reilly TD has today welcomed the announcement by Mr Tony O’Brien, Director General Designate of the health service of the appointment of new National Directors and a Chief Financial Officer. The announcement paves the way for a significant change in the management of our health service, and is another important step towards the development of a fairer, more effective health service with the introduction of Universal Health Insurance.

Government action and plans to radically reform and improve our health services can be viewed in Future Health – a Strategic Framework for Reform of the Health Service 2012-2015.

The appointments now put in place key disciplines for establishing a new Directorate structure to manage the nation’s health services. The Directorate structure will be established shortly with the passing of the Health Service Executive (Governance) Bill 2012.

Purchaser-Provider Split

One of the anomalies of the health services as they currently exist is that the HSE both provides and purchases health services. This basic anomaly is an impediment to the most effective development of safe, efficient services. Under Future Health the Government will put in place a purchaser/provider split allowing for the management of the provision of services to work to the optimum while separately purchasing the services through a Health Commissioning Agency.

The establishment of the Directorate structure in the HSE is designed to move the organisation of health services towards the purchaser/provider split. With the passing of the Health Service Executive (Governance) Bill 2012, Minister Reilly will put in place a Directorate involving key areas of management. It will be the job of the Directorate to manage the transition of our services towards the purchaser/provider split.

Future Health – a Strategic Framework for Reform of the Health Service 2012-2015 states “The Directorate management teams involved in performance contracting and financing of services will be subsumed into the new commissioning body the Healthcare Commissioning Agency in 2014 where they will be charged with continuing to drive performance improvement through value based purchasing. At this point the HSE will effectively be dissolved. There will be a consultation with staff on all relevant issues which may arise in this context”

Hospital Groups

The appointment of the new Directors also comes in the week of the announcement of the Hospital Group structure. In the most radical reform of hospital services in decades, the country’s 49 acute hospitals are now being arranged into six Hospital Groups which will allow for a more strategic, effective development of services. The Hospital Groups will ultimately give way to Hospital Trusts established by statute which will have “earned” their level of autonomy. The Hospital Groups will clearly be providers of services. The new Hospital Groups will be able to concentrate on arranging their hospitals in a manner to deliver services in the most safe, strategic way as we move towards the payment of services by a ‘Money Follows the Patient’ principle. The Health Commissioning Agency will purchase services from the Hospital Groups.

Commenting on today’s appointments Minister Reilly said “I am pleased that persons of such experience have been selected to these key positions. Once the Governance legislation has been passed we will establish the Directorate structure. We now have people of high calibre with considerable corporate and regional knowledge who are well placed to prepare for the execution of the purchaser/provider split that we need. These appointments, taken together with the Hospital Groups announcement of this week, are further clear evidence of this Government’s action to provide a fairer, safer, more efficient health service with better outcomes for patients”.