Statement by the Department of Health and Children
An article in a newspaper of 5th January, under the by-line ‘Anger at duplication of staff in the Department of Health’ displays a lack of understanding of the respective roles of the Department of Health & Children and the HSE. The Department and the HSE have very different functions.
In simple terms, the HSE delivers health services while the Department is responsible for monitoring their provision (to ensure that they are in accordance with Government policy), and for the overall policy framework within which services are provided. This includes preparing legislation and monitoring the performance of the HSE.
Many other Government Departments have significant agencies within their remit that deliver services to the public, – eg the Department of Justice (the Courts Service and the Prison Service); the Department of the Environment (local authorities, Environmental Protection Agency); the Department of Transport (CIE Group) etc. There have been no suggestions that these Departments should have little or no staff dealing with the policy aspects of these areas. It is not clear why any such approach should be taken in relation to the health services either.
To respond in detail:
In relation to cancer services, the four staff work very closely with the National Cancer Control Programme, but again they have very different and distinct functions. They monitor implementation of the Programme, work with the National Director and his staff in removing any obstacles to progress, deal with a range of legislative and Ministerial responsibilities that cannot be discharged by the HSE, and keep the Minister informed in relation to all aspects of cancer services.
The Mental Health Unit forms part of the Office for Disability & Mental Health, which spans four Government Departments and aims to develop a more integrated, whole-of-Government approach to policy and service delivery for people with disabilities, including people with mental health difficulties. A key priority for the Mental Health Unit is to bring a fresh impetus to the implementation of A Vision for Change in the HSE and to work with other Government Departments to ensure progress on recommendations which fall outside the remit of the health sector. The Unit is also working with the Department of Justice, Equality & Law Reform to achieve greater co-operation between the health and justice sectors on matters relating to people with mental illness who come in contact with the criminal justice system.
In relation to work of the Parliamentary Affairs Division and the claim that ‘’almost all the questions submitted by TD’s are forwarded onto the HSE for answer”, it should be noted that in 2008, 6137 PQs were processed by this Department. Of these, 2522 (41.1%) were answered directly by the Department and 3063 (49.9%) were referred to the HSE for direct reply to the Deputy. A further 485 (7.9%) were partially answered by this Department and partially referred to the HSE and 67 (1.1%) were referred or partially referred to agencies other than the HSE (e.g. National Cancer Screening Service, National Cancer Registry, NTPF, Food Safety Authority of Ireland).
The National HR and Workforce Planning Division consists of the following four units:
- Medical and Dental Unit,
- Nursing Policy Unit,
- Professional Management and Support Unit,
- Health Reform Unit.
The staff of the Division includes nursing, midwifery and therapist advisers seconded to the Department from the wider health sector to advise both the Minister and the Department on professional matters.
The Division has responsibility for inter alia, the following policy areas:
- Statutory framework for the regulation of various health care professionals, such as doctors, nurses, therapists and social workers. (This includes the implementation of the Medical Practitioners Act 2007 and the Health and Social Care Professionals Act 2005, the provisions of which were both developed in the Division. In addition, a new Nurses and Midwives Bill is currently at an advanced stage of preparation).
- Public Service Pay and Pension Policy as it applies to the entire public health service (ie the voluntary hospitals and intellectual disability agencies as well as the HSE). This includes approval of the terms and conditions, including salaries, of all senior management grades across the public system.
- National Level HR/IR issues relating to the health sector such as the medical consultants’ contract negotiations, the European Working Time Directive as it applies to junior doctors, the reduction in the working hours of nurses, National Partnership, Towards 2016, and the transfer of core functions from the health sector to the Department of Social and Family Affairs.
- Workforce Planning for the health services generally (including public and private)
- Health Agency Rationalisation Programme (a total of 15 health agencies have been identified for integration/amalgamation).
- Co-ordination of Health Reform Programme, including restructuring of HSE.
The Health Promotion Policy Unit undertakes a number of tasks which are separate and distinct from the role and activities of the HSE. These include:-
- Inter-Sectoral working with other Government Departments aimed at addressing the wider determinants of health. Inter-Departmental working takes place in relation to obesity, nutrition, alcohol policy and domestic, sexual and gender based violence.
- Agreement and monitoring of codes of practice on alcohol marketing, advertising and sponsorship.
- Working with the Department of Justice, Equality and Law Reform on alcohol licensing policy and legislation. Working with the Department of Finance and the Revenue Commissioners on policy in relation to alcohol excise duty. Drafting of legislation in relation to the labelling of alcohol products.
- Development of a National Nutrition Policy for the Irish population.
- Undertaking and publishing national research on the health and lifestyle behaviours of the Irish population.
- Representing Ireland at North/South, EU, and international level and contributing to international efforts on a range of issues relevant to the Health Promotion area.
- Leading in the development of a new cardiovascular Health Strategy, including Stroke.
The Office for Older People was established by the Government at the beginning of 2008, specifically to support the development of comprehensive joined-up policy across all Government Departments in relation to older people. The current priority tasks of the Office are to process and have enacted the new Nursing Homes Support Scheme Bill (Fair Deal), introduce the new standards and regulations for residential care settings for older people, monitor the implementation and funding of the Health Repayment Scheme and the development of a new National Positive Ageing Strategy, which is to include the development of operational plans by Government Departments clearly setting out objectives relating to older people. In discharging its mandate, the Office works closely with all Government Departments, the HSE, HIQA and NGO’s
Many of the High Level Objectives of the Department as set out in the Department’s Statement of Strategy are linked to the effective organisation and delivery of services by the HSE. This underlines the need for a close and effective working relationship between the two organisations. However, there is no question of a duplication of responsibilities or activities between the two organisations, nor of any officials “doing nothing”.