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Health Service Reform Programme

Government announce radical reform programme to provide better patient care, better value for money and better management

18 June 2003

The Government today announced the most extensive reform programme of the Health System in over 30 years. The programme´s priority focus is improved patient care, better value for taxpayers´ money and improved health care management.

Launching the programme, the Minister for Health and Children, Micheál Martin and the Minister for Finance, Charlie McCreevy, said that "the central aim of the reform programme published today is ultimately about providing an improved level of patient care for the increasing number of citizens availing of the Irish Health Service each year."

The Ministers drew particular attention to the significantly increased level of investment in the health service since 1997, which is now at record levels and is equivalent to over €2000 for every man, woman and child in the country and said "it is essential that we achieve greater value-for-money for a service which accounts for over a quarter of all public spending in the interests of not alone the patient but of every taxpayer in the country."

The reform programme includes measures which will impact on every element of the health system and will draw on the conclusions and recommendations of two reports which were also published today:

• the Commission on Financial Management and Control Systems in the Health Service (the Brennan Commission); and
• the Audit of Structures and Functions in the Health System (Prospectus).

Publishing the reports, the Ministers said that "the Government has repeatedly said that a service which accounts for over €9 billion of taxpayers’ money needs fully modernised financial management practices. The approach announced today will put the right mechanisms in place to help ensure that this money is well spent in the system. The public have a right to such an assurance."

The measures announced include:

• A major rationalisation of existing health service agencies. This involves the consolidation and amalgamation of 32 agencies including the abolition of the existing health board structures.
  
  
• The establishment of a Health Service Executive which will be the first ever body charged with managing and delivering the health service as a single national entity.
  
  
• The immediate establishment of an interim National Hospitals Office to take early action in reforming the hospitals sector. This Office will be one of three core parts of the Health Service Executive - the others being a Primary, Community and Continuing Directorate to manage non-hospital services and a National Shared Services Centre.
  
  
• A Primary, Community and Continuing Care Directorate with four regional health offices and 32 local health offices to deliver regional and local non-hospital services.
  
  
• The reorganisation of the Department of Health and Children, to ensure improved policy development, oversight and evaluation of service delivery.
  
  
• The establishment of a Health Information and Quality Authority to ensure that quality and effectiveness of care is promoted throughout the system.
  
  
• The devolution of responsibility for budgets to the people actually in charge of delivering services.
  
  
• The complete modernisation of supporting processes (service planning, management reporting, etc.) to improve planning and delivery of services.

Minister Martin said that the current health system has been in place for over thirty years, but that demands faced by the system have completely changed. "We have already published the Health Strategy which sets out, area by area, the objective of having a system where everyone has access to high-quality care when they need it. It is clear that we have to modernise our structures to meet this objective and that is what we are doing in the health reform programme."

Minister McCreevy endorsed the Brennan Commission conclusion that "there is scope to significantly increase the efficiency and productivity of the health system in Ireland - in effect to provide better services to those who require healthcare and to provide better value for the substantial investment in health services".