Current system would have collapsed in on itself

THE current health system would have collapsed in on itself, becoming ever more expensive and less capable, the Prospectus Report found.

"To continue in the current direction of development of structures and functions will lead to even greater fragmentation of critical functions, potentially resulting in an ever increasing dilution of the cost-effectiveness, performance and manageability of healthcare services in Ireland," the report reads.

The report's recommendations concentrate on four main areas:

A more consolidated health structure.

Better supporting structures and value for money.

More accountability.

Reorganisation of the 58 existing health agencies.

The report's central premise is that a lack of fundamental structural reform constrained the ability of the system to deliver despite the willingness of health staff to improve things and

increasing investment levels.

Crucially, the findings of the Prospectus audit also outline the absence of any consistent focus on the health consumer and strongly recommends local politicians be eliminated completely from the health structure.

"Tensions between local representation, decision making and the delivery of national and regional strategic objectives hinder decision making," the report concluded.

As widely leaked, the report proposes a radical shakeup of almost the entire structure of the health system.

The 11 health boards and the Eastern Regional Health Authority (ERHA) will be abolished and replaced by a new Health Services Executive (HSE).

The HSE will effectively take over many of the functions controlled by the Department of Finance and will control all hospitals through a National Hospitals Office as well as managing primary, community and long-term health services.

Four regional health offices will also be established overseeing local health offices which will provide a standardised range of services.

Although no immediate extra funding will be available for implementing the recommendations of the Prospectus Report, Health Minister Micheál Martin said an interim Health Services Executive and National Hospitals Office will be established by autumn.

Failure to implement the full recommendations of the Prospectus Report on the structures and functions of the health service could lead to an even worse health system, the report's

authors warned.

The report also warns that a number of Government initiatives already underway, must also be implemented in full.

"There is a significant risk an incremental response to putting in place the structural and functional supports for their respective recommendations will exacerbate rather than improve the complex nature of today's system," it warns.