Speech by Micheál Martin T.D., Minister for Health and Children, at Inaugural Meeting of the Board of the Interim Health Service Executive

Good afternoon ladies and gentlemen.


I am delighted to be here this afternoon at the inaugural meeting of the Board of the Interim Health Service Executive. Today represents a very important step in the implementation programme for the Health Service Reform. It marks the end of the initial phases, which commenced with the launch of the Health Strategy – Quality and Fairness A Health System for You – and then continued with the production of three key reports, which collectively form the basis for the Government decision on the programme of reform, and the start of a whole new way of delivering our health and personal social services.

The establishment of this Board of the Interim Health Service Executive changes forever the landscape of the Irish Health Service. The Interim HSE and this board are now the key elements not just in transforming the delivery system for Health in line with the Government decision, but in achieving the goals and objectives set out in Quality and Fairness for the provision of a world-class health service. The creation of the Health Service Executive as a single entity to oversee that service provision and the establishment of this board are very significant developments.

I know that nobody here underestimates the size or complexity of the challenges ahead. The Government decision represents a fundamental shift in the design of the structures that currently deliver our Health Services. It is the most significant change ever conceived for the existing system that has been in operation now for over thirty years. Change of this order is difficult and even more so when the change involves structures, and business processes as well as culture and behaviour.

Role as Stewards

This board will now become the stewards of the new enterprise. Your stewardship will require you to oversee the expenditure of the annual health budget of €10 billion, through a unitary system, to deliver health and personal social services to the population of Ireland. The HSE will now design the delivery system through the three pillars of a National Hospitals Office, Primary Continuing and Community Care Directorate and a National Shared Service Centre.

Obviously this is not a “green field site” and these changes have to be achieved while maintaining existing levels and standards of service delivery. Your stewardship role will have different phases over the next three years. The initial phase is putting in place the appropriate structures and people to ensure the smooth transition to the new service delivery model. In the medium term the challenges will involve ensuring that the new system is capable of delivering the quality and quantum of service that is demanded by the public, and to holding the executive to account for its management of the health delivery system.

Progress to Date

I would like to update you briefly on the huge amount of work has been undertaken since the Government decision in June. The Secretary General and I consulted with the senior management teams of all the major agencies immediately after the decision was announced. I also commissioned the Office for Health to undertake a major consultation and information sharing exercise over the subsequent months. During this exercise they had direct contact with over 20,000 of the 120,000 people employed in the health service. A report on this consultation was produced in November, and there are copies available if any of you wish to read it. During September the Project Office determined thirteen distinct areas where further thinking was required to elaborate on the Government decision. For each of these areas an action project group was established and was jointly chair by a Chief Executive Officer of a Health Board and a member of my Department´s Management Advisory Committee. The project groups were made up of key people from throughout the health system. The action projects were:

  1. Health Service Executive
  2. National Hospital Office
  3. Primary Continuing and Community Care
  4. National Shared Service Centre
  5. Health Information Quality Authority (HIQA)
  6. Finance
  7. Governance
  8. HR/IR
  9. Communications
  10. Legislation
  11. Streamlining
  12. Restructuring
  13. Information and Communications Technology

Following an intense period of activity the action project groups produced reports by the end of December. These reports attempt to address some of the difficult issues, which need to be resolved, to implement the new structures. The project office is currently producing a composite report of all the main findings. They are also preparing a general commentary and analysing the reports to identify where further work may be required. Work is also well underway in developing a comprehensive project plan for phase II onwards. All this documentation will be made available to the members of the board, and will I hope, prove useful to you in making some of your decisions over the coming months.

HSE Activities

In spite of the progress made to date by the Project Office there are a number of core tasks, which you must now undertake. The board must initiate a process to recruit a Chief Executive Officer for the Interim HSE. This will include determining the appropriate role for the CEO. This person must have the knowledge, skills and experience to deliver on the change agenda whilst also ensuring high quality service delivery.

National Steering Committee

Although the remit of this board is clearly very challenging it is not operating in isolation. This week I appointed a National Steering Committee to oversee the implementation of the Health Service Reform Programme. This Steering Committee will report on a regular basis to the Cabinet Committee on the Health Strategy, ensuring that the Government is kept fully informed on all important issues. As part of this process the board will be required to report on progress on activities under it’s remit to the National Steering Committee. The Steering Committee will oversee the various strands of the reform programme, ensuring direction and confirming that objectives are delivered. The National Steering Committee will be chaired by:

  • Kevin Kelly; and the Committee members are
  • David Hanly from the National Taskforce on Medical Staffing
  • Michael Kelly, Secretary General of the Department of Health and Children
  • Dermot McCarthy, Secretary General of the Department of An Taoiseach
  • David Doyle, Second Secretary of the Department of Finance
  • Denis Doherty, Chief Executive Officer of the Health Board Executive
  • Sean Hurley, Chief Executive Officer of the Southern Health Board
  • Maura McGrath, Management Consultant
  • Michael Dempsey, Partner in Bristol Myers Squibb

Four Work Streams

Among the challenges you face is the fact that the reform programme is now moving forward in four separate but inter-related streams. The first stream is the work of this board. The second stream relates to the Hanly report and implementation of the phase I sites, and development of phase II of the report. The third stream is the ongoing work of my Department in the reform programme including, inter alia, the restructuring of my Department to play it’s new role post reform and the planning and management of the implementation of the reform programme by the Project Office. The final strand is the work of the CEOs of the Health Boards in continuing to deliver services, whilst also actively engaging in the change programme. The leaders of these four inter-connected streams must operate in partnership.

Your role in supporting this process is to develop mechanisms to communicate regularly with the Project Office to ensure a fully integrated programme and directly with the other streams as appropriate. The Project Office is a key resource to you and will continue to play the central role in supporting the implementation of the overall reform programme.

Finally I like to say how pleased I am with the membership of this board. You have each been selected based on the skills and competencies you possess, rather than as representatives of any agency or body. I know the challenge ahead is significant, but I and indeed the Government believe that this programme of reform is essential for the improvement of our health and personal social services. I have every confidence in your collective ability to meeting this challenging agenda, and I would like to wish you every success over the next three years.