The HSE has been ordered to merge hospitals into new administrative groups with a single budget and a staff ceiling as part of plans to cut costs, high-level administration, and patient waiting times.
Health Minister James Reilly confirmed the move in correspondence sent to HSE chairman and recently retired Department of Health secretary general Michael Scanlan.
Under the plan, public facilities will be told to combine resources to help improve frontline services and the wider system.
The move, Dr Reilly said, will eventually lead to the creation of independent not-for-profit health board trusts similar to those in the NHS in Britain, and is another step towards a universal health insurance system.
While there is no set timeline in place and the exact make-up of each group has yet to be discussed, Dr Reilly argued the closer working relationship between different hospitals would benefit patients.
“There is a significant benefit to be gained by organising the country’s hospitals into groups,” he said.
“It will allow for group chief executives to develop initiatives and solutions that take account of the synergies between a number of hospitals in the same geographic region, thus ensuring quicker treatments for more patients.
“It is very important to set out clearly and transparently how the health reform programme is being implemented so that patients, their families and the staff delivering those services, know what to expect in the coming months.”
The move has been imposed on the HSE under a rarely used part of the Health Act 2004 legislation which created the service. Under Section 10, the health minister is allowed to order the HSE to implement set policies regardless of the HSE board’s view.
The only other time this section of the act was used was to impose a public-private co-location policy by Mary Harney.
In addition to potentially reducing waiting lists as hospitals would work more closely with each other, Dr Reilly said the group setup would also provide a “clearly defined” budget and employment ceiling for each grouping.
This, it is believed, will be a more appropriate way to budget for services in particular regions.
The “executive team/board” of each group will also be given the authority to reconfigure services once changes adhere to already established frameworks.
The first merger system was set up in Galway at the start of this year, leading to considerable local concern over the impact on service in smaller hospitals within the new group.
Since January, University Hospital Galway, Merlin Park Hospital, Roscommon General Hospital, and Portiuncula Hospital in Ballina-sloe, Co Galway, have been part of a group managed by chief executive Bill Maher.
Under the scheme, Mr Maher is responsible for group performance, with the four hospitals sharing a single governance model, one budget, and one employment ceiling.
Dr Reilly has said there would be “appropriate consultation” before further hospital groups were set up.
He said a framework document for the development of smaller hospitals — which would outline their specific role in these new groups — would also be published “very shortly”.
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