Labour: Health service a bureaucratic Frankenstein

THE country is “stuck” with the Health Service Executive (HSE), but it can and should be reformed, Labour said yesterday.

Announcing a six-point plan to overhaul the organisation, Labour leader Eamon Gilmore said the HSE had become a “bureaucratic Frankenstein” which had failed to deliver a better service for patients.

“The HSE was ill-conceived, ill-designed and ill-executed,” he said. “[It] suffers from over-centralisation, confused lines of authority, and duplication of functions.”

Mr Gilmore said that when the Government established the HSE in 2005, clear objectives had been set.

The structure was supposed to make the health system more responsive to the needs of patients, more accountable and provide better value for money.

“It has failed to deliver on all three counts,” he said. Nonetheless, he admitted the HSE could not be dismantled in favour of a new system at this stage.

“I think it is probably fair to say we’re stuck with it,” he said, pointing out that up to three years would be required to “stand down” the HSE and this would only take the focus off the patient. “We have come to the conclusion that what we would do if we were in government is we would try and fix it… And we think it is possible to do that,” said Mr Gilmore. Labour’s six-point plan would involve:

* Establishing clear lines of authority within the HSE, with as much decision-making as possible devolved to local level.

* Making the Health Minister answerable for all aspects of health service policy and delivery.

* Offering a voluntary early retirement, redundancy and redeployment scheme to remove unnecessary layers of management.

* Giving each hospital and community care area the power to spend its own budget in line with national policy.

* Establishing local accountability structures, under which public representatives would be able to raise questions about the provision of local services.

* Requiring each hospital and community care area to establish a patient liaison programme so that patients who have concerns can have their voices heard.

Mr Gilmore and Labour’s health spokeswoman, Jan O’Sullivan, were particularly insistent that Health Minister Mary Harney would have to reassume full and proper accountability for the HSE.

“The notion that the minister and her department are responsible for policy only [rather than implementation] has allowed the minister to duck responsibility for almost everything,” said Mr Gilmore.

Ms O’Sullivan admitted Labour had not fully thought out the proposed voluntary redundancy scheme, saying it did not know how much it would cost. But she said the focus would be on removing unnecessary “layers at the higher level” rather than frontline staff “at the coalface”.


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