Consultants call on Health Minister to be 'more ambitious' with HSE restructuring

Consultants call on Health Minister to be 'more ambitious' with HSE restructuring

The Irish Hospital Consultants Association has said that the proposed restructuring of health services announced by the Health Minister Simon Harris today does not go far enough.

The Minister has created six regional health boards, a structure that was there before the HSE, which will devolve power from the central HSE.

The six regional bodies will have more autonomy to make decisions at a local level and be set up with their own budgets based on population.

The IHCA wants hospital and community health services to be merged in the different regions, warning that greater alignment between the two services "will not ensure integrated, joined-up healthcare delivery for patients".

They said the geographic alignment of existing hospital groups and community health organisations areas (CHOs), rather than a genuine integration of these services, risks losing an opportunity for real and meaningful reform.

    The six proposed health board regions

  • Area A - Dublin North, Meath, Louth, Cavan and Monaghan.
  • Area B - A part of Dublin South, Kildare, Laois, Offaly, Westmeath and Longford.
  • Area C - part of Dublin South, Wicklow, Wexford, Carlow, Kilkenny, Tipperary South and Waterford.
  • Area D - Cork and Kerry,
  • Area E - Limerick, Tipperary North and Clare.
  • Area F - Galway, Mayo, Sligo, Roscommon, Leitrim and Donegal.

They said that if structures are not merged the service "will continue to be poorly integrated and burdened with additional layers of redundant bureaucracy".

"This will lead to scarce resources being diverted away from frontline patient care services."

President of the IHCA, Dr Donal O’Hanlon: “Today’s proposals need to go further and take a more ambitious view. We must ensure that our health services work together holistically.

"This approach must be hard-wired from the start with structures which ensure that patients can access and move between health care services across their lifetime and with ease, as and when they need them. Today’s proposals, as currently outlined, do not guarantee that this will be the case”.

Dr O’Hanlon called for a full integration of the community and hospital healthcare services.

He said: “For this realignment to work effectively all hospital and community health services should be merged, and not just aligned, into one organisation within specific geographic areas.

"If structures are not merged the service will continue to be poorly integrated and burdened with additional layers of redundant bureaucracy, which will divert resources from frontline patient care services.

"The issue of large numbers of patients who have been clinically discharged from hospitals and are ready to leave hospital but cannot do so due to the lack of homecare or nursing home supports is just one example of this lack of integration.

The IHCA also believe that merged regional health groups are also critical for delivering promised increased bed allocations - a minimum of 2,600 acute hospital beds and 4,500 additional step down residential beds.

They said that today’s proposal "risks the creation of a further layer of administrative and bureaucracy".

Dr O’Hanlon said: “Merging the administration and governance of community and hospital services would remove duplication of bureaucracy, and establish functioning independent boards that promote effective, accessible and accountable governance, providing better co-ordination and delivery of services.

"The merger of structures should also replace the current institution-based budgetary focus with one that is centred on patient care and outcomes”.

Dr O’Hanlon also said that the new boards and governance for such new integrated organisations should contain patient representatives.

He said: “Membership of these boards should be drawn from a diversity of backgrounds and sectors and include non-executive directors and executive directors, including hospital consultants.

The boards should include patient representatives as co-participants in resource allocation, decision-making and formulation of strategy.”

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