The Department of Health has said it told the former Minister for Health, and current Minister for Children, James Reilly that more work was needed
on controversial reform proposals for replacing the HSE.
Last Saturday, The Irish Times reported that official Department of Health briefing material given to the new Minister for Health Leo Varadkar in July described proposed structures for replacing the HSE, which had been championed by Dr Reilly, as "unworkable". Fianna Fáil said the revelations meant Government health policy was in tatters and raised questions about Dr Reilly's continued presence in the Cabinet.
Asked if it had expressed similar concerns on proposals for the reform of health structures to Dr Reilly when he was in office to those given to Mr Varadkar, the Department of Health said: “Discussions were held with Minister Reilly regarding further work that needed to be carried out on the proposed structures in order to achieve the objectives of the reform programme set out in (the Government’s ) Future Health (document).
Reform proposals
On Sunday, a spokesman for Dr Reilly said his reform proposals had been in keeping with agreed Government policy. The spokesman added it was “not uncommon for a Government department to express concerns at proposals for very significant change” .
In November 2012, the Government approved a three- stage strategic reform plan for the health sector, known as Future Health. The second stage of this involved the dissolution of the HSE and the division of the health service between purchasers and providers. This was to lead to the establishment of a system of universal health insurance.
In order to bring this about, a number of bodies were to be set up, such as a healthcare commissioning agency, a pricing office and a patient safety agency; revised structures for primary, social and mental healthcare were to be established and hospital groups transformed into trusts.
Proposed structures
In the briefing material given to Mr Varadkar on his appointment, the Department of Health said it considered the proposed structures to be “an unworkable construct”.
It said the full implementation of the policy proposals “would lead to a wide range of new statutory organisations”.
The Department of Health said yesterday that it had been working towards delivering on the structural reform agenda for the health system primarily in line with the course set out in the Future Health document and other papers.
“While Future Health set the broad direction of travel for reforming the system, it was always made clear to [sic] that an incremental or iterative approach to implementation was being taken and that further work was required in order to translate the concepts into a practical reality.
“The briefing document referred to in the media reports clearly stated that work is continuing on the development of a coherent legal, governance and service delivery structure as well as a description of how the functions and responsibilities of the existing service will be dispersed among the entities of the reformed system.
“Changes will continue to be made on an administrative basis while we develop the appropriate underlying legislation. This work and approach was approved by the former Minister for Health and is being continued by Minister Varadkar.”
