Press Release

Mary Harney TD, Minister for Health and Children, announces the establishment of an Expert Group on Resource Allocation and Financing the Health Sector

The Minister for Health and Children, Mary Harney, TD, today (Wednesday, 1st April) announced the establishment of an Expert Group on Resource Allocation in the Health Sector. The Group will be chaired by Professor Frances Ruane, Director, ESRI.

The Expert Group will examine how the existing system of resource allocation within the Irish public health service can be improved to support better the aims of the health reform programme.

These aims are improved health status and outcomes for people; quality assurance and patient safety; speed and equity of access, and sustainability, within the resources that are provided by the Government and Oireachtas.

The Minister said, “One of the most important drivers of change is the way we allocate resources.

“I want to see greatly-improved links between resources and patients’ interests. I want to make money follow the patient, that is, to support better each person’s health status and outcomes from healthcare.

“I am asking this Group to do the detailed, complex work to recommend the best ways to achieve this, within the level of resources available to health. It is a highly complex area where there are no simple answers, but I am confident that the members of this Group will give the sophisticated scrutiny to the issues that is needed.

“As I said earlier this year, we have to move away from simply funding inputs to health services, which we have done traditionally, such as numbers of staff, numbers of beds or numbers of machines. And it’s not just about outputs – for example, hospital activity and treatments – but more importantly, aligning resources towards the achievement of the best outcomes for patients.

“This goes much further than considerations like paying per procedure in hospitals or fee-per-item payments to doctors. It can be as much about re-balancing resources towards better care for patients with chronic illnesses so that they don’t need to go to hospital and, for example, incentivising hospitals for lower lengths of stay for patients and more treatment on a day case basis.

“It is also wider than changing the way we allocate resources to hospitals, because it also covers primary care and community care, including mental health services, for example.

“The HSE has already begun work on ways of improving the efficiency and effectiveness of resource allocation. The Expert Group will build on this and work with the HSE to find the most effective way to apply a given level of funding to achieve health policy goals.

“The core issue is about how we allocate resources to support our objectives for health. The method by which we raise public funds – whether we finance healthcare through taxation or compulsory private or social insurance – is not the starting point.

“However, if the very method by which finance is raised is shown by the Group to influence the best allocation of a given level of resources for the outcomes we want, the Group is asked to make recommendations in that respect.

“The Group will be required to conduct its examination and formulate its recommendations on the basis of the existing amount of public funding for health. It is important to work within that budgetary context, because the more realistic the context, the more likely that recommendations can ultimately be implemented.

“I believe the work of this Group will prove to be far-reaching and of great value for patients and the health services for many years. I thank the Chairperson, Prof. Frances Ruane, and the members, for agreeing to take on this strategically-important task, and I very much look forward to the outcome of their work.”

Terms of reference

The Minister has asked the Expert Group:

  • to analyse the strengths and weaknesses of the current resource allocation arrangements for health and personal social services;
  • to recommend appropriate changes in these arrangements, which would support and incentivise the achievement of the core objectives of the health reform programme;
  • in the light of its work, to take a view on the most appropriate financing mechanism for the Irish health service, and
  • to base its examination and recommendations on the existing quantum of public funding for health.

The Membership of the Expert Group is attached. The Group has been asked to report to the Minister for Health and Children and the Minister for Finance by April 2010.

Membership of Steering Group on Resource Allocation


  • Prof. Frances Ruane – Director, ESRI

Department of Health and Children

  • Dermot Smyth – Assistant Secretary, DOHC


  • Liam Woods – Director of Finance, HSE


  • Prof. Rowena Peechenino – Head, Dept. of Economics, Finance and Accounting, NUI Maynooth
  • Prof. Charles Normand – Edward Kennedy Professor of Health Policy and Management, University of Dublin, Trinity College

Voluntary Hospitals

  • Ian Carter – CEO, St. James’s Hospital
  • Nuala Hunt – Board of Governors, Holles Street

Medical Consultants

  • Prof. Arnold Hill – Professor of Surgery at RCSI and Beaumont Hospital
  • Prof. Peter Kearney – Consultant Cardiologist, CUH
  • Dr. Colin Doherty – Consultant Neurologist, St. James’s Hospital

Non-acute Sector/Primary Care

  • Prof. Andrew Murphy – Department of General Practice, NUI Galway

Non-Statutory Disability Sector

  • Brendan Broderick – CEO, Sisters of Charity, Moore Abbey

Public Sector

  • Manus O’Riordan – Head of Research, SIPTU

Private Sector

  • Derry Gray – Partner in charge of Consulting, BDO Simpson Xavier
  • Pat Lyons – Chief Executive, Bons Secours Group