Minister's biggest task will be to implement three key reports

Task facing Harney: By accepting the post of Minister for Health and Children, Ms Harney, has taken on one of the toughest ministries…

Task facing Harney: By accepting the post of Minister for Health and Children, Ms Harney, has taken on one of the toughest ministries in Government. Her predecessor, Mr Martin, has left the stage littered with well-researched reports into the future needs of the health service.

What is needed now is someone with the courage to make hard decisions and to implement change.

One of the most visible areas in the health system is a hospital's accident and emergency department. It is where people go when sudden, serious illness strikes. To say A&E departments have not been functioning adequately is an understatement. With the so-called "clinical winter" months approaching - when people with chronic heart and lung disease become acutely unwell - we are about to see A&E departments bursting at the seams yet again. Some 40 or more patients will be sitting on trolleys for days at a time in each department.

They and their families will be extremely upset at the failure of an apparently well-funded health system to offer them a bed and the quality of medical care they deserve. Welcome to Angola, Ms Harney: this is one of the first major challenges you will face in office.

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In seeking to deal with the accident and emergency problem the new Minister could do worse than pay a visit to Kilkenny general hospital where acutely ill patients are treated and admitted to a bed within 2-3 hours of presenting to hospital. By developing the concept of a medical assessment unit, doctors and nurses at the hospital have shown there is an alternative to the current casualty bottleneck.

The issue of medical insurance and who will pay for past negligence claims against consultants will be one of the first files to land on Ms Harney's desk.

The British-based Medical Defence Union (MDU) has written to over a dozen consultant obstetricians and a number of consultant surgeons rejecting their request for assistance in specific legal cases.

With the annual meeting of the Irish Hospital Consultants' Association taking place the weekend after next, the pressure will be on to broker a deal between the Department of Health and the MDU in order to avoid industrial unrest among the Republic's top doctors.

But it is the implementation of the three key reports into the health system that is the biggest task facing the Minister. While ideologically close to the findings of the Brennan Commission on Financial Management and Control Systems in the Health Service, Ms Harney may find the more measured approach of the Prospectus Report easier to implement.

The big question is, what will she do with Hanly? It suffered because of poor presentation and the mere mention of it now sets local politicians' teeth on edge. Will Ms Harney, coming from a different political background to Mr Martin, find it easier to implement the closure of smaller hospitals throughout the State? Or will she quietly bin the report and start again with a clean sheet?