Press Release

Statement on Health Service Executive (Governance) Bill 2012

18 July 2012

The Minister for Health Dr James Reilly has today published the Health    Service Executive (Governance) Bill 2012. The legislation, approved by the    Cabinet yesterday (Tuesday 17th July), will pave the way for major changes    in the design of our health services. “For too long the treatment of    patients in our health services has had to conform to the needs of the    system” said Dr Reilly “this new Directorate structure in the HSE will    allow us to redesign the system to put the needs of the patient front and    centre”.

The legislation will allow the putting in place of a Director General    and six new Directorates, closely aligned to specific areas of service    such as primary care, mental health, hospitals and more. The new structure    will allow a reorganisation of services to prepare the way for the wider    introduction of the ‘money follows the patient principle’ and the ultimate    introduction of Universal Health Insurance.

“This Government inherited a two tier health system which is inherently    unfair to many citizens. Today’s announcement is a significant step on the    road to the abolition of our two tier health system and its replacement    with a system that responds to our needs and not our financial means”.

Purpose of Bill


The Health Service Executive (Governance) Bill 2012 will:

  • abolish the Board structure of the Health Service Executive (HSE)      and provide for a Directorate to be the new governing body for the HSE      in place of the Board, headed by a Director General;
  • provide for further accountability arrangements for the HSE; and
  • provide for related matters including a number of technical      amendments to take account of the replacement of the Board structure by      the Directorate structure.

No change to legal basis of the HSE


The legal status of the HSE under the Health Act 2004 does not change    under the Bill and HSE employees will remain the employees of the HSE.


In line with health reform policy, the Bill is intended to:

  • make the HSE more directly accountable to the Minister for Health,      who in turn is accountable to the people through the Oireachtas; and
  • help prepare the service delivery for the next phase of the health      reform programme.

Provisions in the Bill build on existing accountability arrangements    under the Health Act 2004.


Under the Bill, the Directorate will consist of a Director General and    other directors.

The legislation provides for an alteration to number of Directors if    later required. The Director General will be a member – and chairperson –    of the Directorate.

The Directorate will be accountable to the Minister for the performance    of the HSE’s functions as well as its own. As chairperson, the Director    General will account to the Minister on behalf of the Directorate in    regard to how the HSE’s functions are performed. He or she will do this    through the Secretary General of the Department of Health.

How things will work

The HSE has responsibility for the organisation and delivery of health    services and the Directorate will be accountable to the Minister for the    performance of HSE functions – it will have to explain its decisions.

The Bill allows the Minister to issue directions to the HSE on the    implementation of Ministerial and Government policies and objectives    relating to HSE functions where the Minister believes that the HSE is not    having sufficient regard to such objectives or policies in performing its    functions.

The Minister will also be empowered to specify priorities for the HSE    which the HSE must have regard to in preparing its service plan.

The Minister may establish performance targets for the HSE in regard to    these priorities.

Directions, priorities and targets won’t be made in relation to    individual patients or service users.

Outside the Bill

In anticipation of the legislative changes, the Minister intends that    the HSE would recruit and appoint heads of health & wellbeing,    hospitals, primary care, mental health and social care. It is envisaged    that employees heading up these service areas and children’s services will    be appointed as members of the Directorate.

Wider Context

The Directorate is a transitional, interim move. Transitional governing    arrangement needed in the HSE to prepare health service delivery systems    for the next phase of the health reform programme.

As the health reform programme advances, the HSE will eventually no    longer exist as its functions move elsewhere. This will take careful    planning and sequencing and further legislation

View the new HSE Governance Structure (PDF)