Health services return to local control
All public hospitals and community services will be overseen by between six and 10 regional managers with authority to make decisions within budgets set by HSE headquarters.
The move comes less than four years after the HSE replaced 11 regional health boards which ran services at local level under budgets set by the Health Department.
The Government and the HSE, however, denied that the changes amounted to a U-turn and were an admission that the embattled executive was a failure.
Sean McGrath, the HSE’s human resources director, described the changes as “organisational modifications”. “The modifications will facilitate more local responsibility and authority and strengthen area structures within the national umbrella of the HSE.”
Health Minister Mary Harney said the changes were not so major as to require amendments to the law which set up the HSE.
“What’s happening here is that an appropriate organisational structure is being put in place. We don’t want a situation were somebody is responsible at local level for running a hospital or for that matter running a unit in a hospital, like a doctor, but the way they do it is being determined at national level. Clearly that does not make sense.”
She said the move was influenced by the report into the breast cancer scandal at Portlaoise Hospital last year which drew attention to the fact that staff were confused about areas of responsibility.
Few details of the restructuring were made available yesterday, despite the fact that a media report four months ago signalled significant changes were planned. The HSE at the time issued a denial of that report although it is now clear it was broadly correct.
Unions received a briefing on the plans yesterday but are waiting for full details as it is expected the changes will require role changes and redundancies.
SIPTU’s national industrial secretary Matt Merrigan said the HSE was trying to undo a mess of its own making. “The system has to be changed but if they had taken account of what we said three years ago when we warned of the problems that now exist, we wouldn’t be in this situation,” he said. “We can accept the broad principle of what this is trying to achieve but how the HSE put it into practice is the key. They’ve been found wanting in the past in handling change.”
IMPACT spokesman Niall Shanahan said the union was not opposed in principle to the plans but said: “The HSE really have to demonstrate the benefits of these changes. It can’t be just an exercise in deflection from current difficulties.”
Donal Duffy of the Irish Hospital Consultants’ Association while describing how the HSE operated as “Moscow central” from the Soviet era, said he was fearful the changes amounted to “rearranging deck chairs on the Titanic”.
HSE officials are to meet with unions again the week after next.
