The Minister for Health has signalled that there will be no politicians on the proposed new regional health board structures.
The return of health boards has been approved by Government when it was sanctioned by Cabinet last Wednesday.
This is a major U-turn in health management policy since the HSE itself was established in 2005 when the 11 regional health boards fell out of favour and were abolished outright.
Now six new regional health areas will be established over the next two years in what is being billed as a major shake-up of the health service. However, the HSE will not be dismantled but somehow or other will continue to run in parallel with the new health boards.
The new structures will see regions in charge of their own budgets, planning and delivery of both hospital and community care.
It is proposed that Laois will be included with Longford, Westmeath, Offaly, Kildare and parts of Dublin and Wicklow to form one of the new regions.
This would be the second largest of the six regions by population, catering for about one million people. Tallaght and St James Hospitals are included in this configuration, along with the Coombe, Naas, St Lukes and the three regional hospitals in Portlaoise, Tullamore and Mullingar.
Minister for Health Simon Harris said this would result in “clear financial and performance accountability” and “devolve authority from the HSE to local regions.”
“We need less bureaucracy, we need more accountability and crucially we need fewer layers between the patient and the health service,” he said.
Minister Harris said that the HSE was “never established in the right way and has never been fit for purpose.”
He said that it will be up to each region to decide how best to deliver health services when they come in to operation as expected in 2021.
“They will receive a budget and they will deliver services for their population within that budget. What we need to work out is the lines of accountability between them, the HSE and the Minister and the Department,” he said.
But in terms of who would make up the Boards overseeing these new regional structures, Minister Harris said that membership would be based on “competency skillsets” and not local councillors.
It is not clear therefore how this would achieve patient and public accountability which is one of the main criticisms levied against the current HSE apparatus.
Previously the health boards were constituted by sectoral and professional representatives, and executive including the CEO and programme managers and public representatives from across the constituent counties.
The Midland Health Board was made up of counties Laois-Offaly and Longford-Westmeath from 1970 until its abolition in 2005. Councillors from the four counties were among the 30 member Board which was chaired by a public representative. Its meetings and administrative HQ were in Tullamore.
Laois councillors Tom Keenan, John Moloney and Marty Rohan were among those to have chaired the Midland Health Board.
Not having any councillors on the membership of the new boards would also be in stark contrast to the current arrangement within the HSE, where the Dublin/Mid Leinster Health Forum has 39 councillors. However, it has no budget, real authority or autonomy and only meets every two months.
Cllr Eddie Fitzpatrick from Portarlington who is a member of Offaly county council and a former chair of the health forum rejected the idea of excluding elected members on the new boards as a good idea.
“Time and time again all they want to do is eliminate elected members and take us away from the decision making as they don’t want any hassle or to answer any questions.
“People are constantly in contact with their local councillors and TDs on health issues and problems with the health service. It’s important to have people on the boards who are on the ground and getting that type of feedback.
“Members of the public will constantly tell you that one of the big problems they have is getting answers or making contact with the HSE.”
The chairman of Laois County Council, himself a former member of the Midland Health Board, Cllr Willie Aird said that he would have to first establish what exactly is proposed and planned before he could give an informed response. In principle he welcomes the return of the health board structures.
“I’d have to check it out first. I will be in contact with Minister to see what exactly is being proposed as we have not been furnished with the details yet.
“If there were no public representatives involved then the question is, who is going to represent the public and public interest as such,” queried Cllr Aird.
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