Under the plans, the Government is seeking to introduce laws to allow them replace managers in hospitals where there are “consistently poor outcomes, patient experiences, and financial management”.
The Irish Examiner understands Mr Harris is adamant that, in light of €800m in increased spending on health services this year, greater accountability is required.
However, the minister is keen to reward and incentivise good or excellent performing hospitals by creating a ring- fenced investment fund to further improve services and research.
“So far, bad performing hospitals who overspend and fail to deliver get rewarded by the end of year bailouts. That has to stop and by making managers directly accountable, we can improve the situation,” a senior Government source said.
Up to this point, only the director general of the HSE Tony O’Brien and some top HSE executives are accountable to TDs and senators, along with their Department of Health counterparts.
However, under new plans, chief executives of poor performing hospitals will be subject to scrutiny from the likes of the Public Accounts Committee (PAC), the Health Committee and the Finance Committee.
Mr Harris and his officials are also seeking to increase the oversight and audit powers of the Comptroller and Auditor General in order to improve the level of accountability in the health service, which has an annual budget of more than €14bn.
Taoiseach Enda Kenny yesterday gave voice to the greater expectation within Government on managers within the health service to perform — now that the normal end of year bailouts for health are no longer available because of new European budgetary rules.
“It is not possible for any minister to continue to go to that well as if nothing ever happened,” he said. “Those people who are in charge of management of hospitals who have budgets to manage had better understand that we cannot have a situation with no further Supplementary Estimates being available.”
There has to be effectiveness in terms of the taxpayer’s money being spent, Mr Kenny said.
“I hope that, in the Minister for Health now speaking to each of the managers in the hospitals, particularly the acute hospitals, there will be an understanding here of getting best effect in the interests of the patient for the moneys that have been allocated,” the Taoiseach added.
In addition, the plans commit to establishing a Performance Management Unit to “provide assistance to hospitals and service providers in reaching their targets”.
Mr Harris, who is a former member of the PAC is keen to ensure basic standards of care in all hospitals are delivered, but believes to achieve that, greater direct accountability is required.
The Government is also seeking to “base health expenditure on multi-year budgeting supported by a five-year Health Service Plan based on realistic, verifiable projections”.
The latest HSE survey of hospitals showed that Galway University Hospital and Our Lady of Lourdes Hospital in Drogheda are the two worst performing hospitals in the country.
In its 2012 grading survey of green, orange, and red, the HSE Healthstat marked both the Galway hospital and Our Lady of Lourdes as ‘red’.
Fianna Fáil’s health spokesman, Billy Kelleher, told the Irish Examiner that he supports any move that increases the accountability within the hospital sector.
Mr Kelleher cautioned against any move to move the hospitals to private trusts, insisting “public funds have to remain publically accountable.”
The Programme for Government has committed to turning the current hospital groups into stand-alone statutory trusts.