Health boards need major overhaul, warns expert

HEALTH boards need to be totally revamped and much of their community care role needs to be transferred to other agencies, a leading expert said yesterday.

The lion’s share of health board spending is not on hospital beds or waiting lists. Up to 57% of spending is on community care, welfare and care of refugees and asylum seekers, civil marriages and providing for the homeless, Association of Health Boards in Ireland chairman Jack Bourke said last night. His comments ahead of today’s annual conference of the association in Kilkenny: “I’ve been talking about health board structures for the past 10 years. When people talk about health boards and health board spending, they talk about hospital beds, waiting lists etc. But the reality is that 57% of our budget goes on community care. This encompasses areas such as supplementary welfare, catering for refugees and asylum seekers and other matters. Health boards have become monoliths, catering for everything from supplementary welfare to care for homeless.

“The Department of Health should create a junior post and take over community care. Then health boards could do what they are supposed to do,” he said.

Other proposed changes in health boards, as well as the abolition of others, aroused fury when first mooted. People were irate. The very same people are now waiting to see what will happen. The greatest fear is the fear of change itself, he said: “When the Eastern Health Board was broken up into three, three years ago, the same thing happened. Now we are talking about two health boards for the entire country. That simply is not workable. There are some health boards which did not live within their budgets and I’m not pointing the finger at anyone. But there are others which did and still have smaller waiting lists.”

Today’s conference has of talks on issues such as food safety; child abuse prevention programmes; environmental protection and its health implications; treatment of waste; health board management and association between health boards and local authorities.