A health board by any other name . . .

They've been away for a while but now they're coming back "in a calm and measured way over the coming 18 months", writes Ann …

They've been away for a while but now they're coming back "in a calm and measured way over the coming 18 months", writes Ann Marie Hourihane.

ISN'T IT great that the health boards are coming back? They may be called "a new devolved structure under which regional directors will be given power to deliver an integrated healthcare service in their area". But we know what it is. It's the health boards. Welcome back, lads.

The health boards had a terrible time of it. They were pilloried and reviled and then, in 2004, they were abolished. It was harsh. It is true that your local health board was never a thing of beauty. They were not efficient and were prone to small-scale jobbery, and your local health board did have a strong sentimental attachment to the institutions which lay within its boundaries. A health board would have preferred - and indeed did prefer - to send its patients to a local abattoir than to bus them to a Mayo clinic. (That's the Mayo Clinic in the United States as opposed to a Mayo clinic in Co Mayo. We'll be waiting quite a while for the latter.)

Now though, our health mandarins have decided that the health boards were not such a bad idea after all. They are now known as proposed modifications which "will be introduced in a calm and measured way over the coming 18 months or so", which is going to make such a lovely change. There aren't going to be 11 of these proposed modifications are there, by any chance? There were 11 of the old health boards - but perhaps it is best not to be too sentimental about the exact number.

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It's best just to be grateful for the opportunity to see old friends in these uncertain times. Who knew we were going to go back to the 1980s quite so rapidly? And this radical and courageous change of heart has only cost us a couple of billion euro. Sure all's well that ends well, when you think about it.

The original health boards fell victim to several wonderful ideas. The first of these wonderful ideas was that the government would rub along much better if it outsourced the whole health problem altogether, outsourcing having been very fashionable at the time. Just get rid of the whole subject: dump it, park it, watch it being towed away. Going forward, as we would put it these days. Get the whole health thing out of the house.

This idea has worked fabulously well, although our parliamentary representatives persisted in asking questions regarding health matters of the Minister for Health. They just didn't realise that questions about health had nothing to do with the Minister for Health any more. Duh! So now they have nobody at all to ask about the health thing.

Another of the wonderful ideas behind the demise of the original health boards was to keep the provision of local health services as far away from local people and their representatives as possible. Strangely, there were reservations expressed about this idea at the time, not least by the executives of the original health boards. Some of them thought it wasn't a bad idea for them to be held accountable to a group which represented local people. That controversy, mercifully, blew over. It was replaced by absolute unanimity that distancing local people from the provision of local health services has worked terribly well. So 10 out of 10 on that one.

The third wonderful idea that killed the original health boards was that people working in the health service would benefit from a hands-off management policy, under which they would not know for whom they working, to whom they were reporting and so on. It is probably fair to say that this wonderful idea was less of an unmitigated success.

Meanwhile, back in the land of the five- figure salary, we are left with a tiny bit of an accountability problem. A journalist, Brenda Power, took to ringing civil servants to put questions to them for local people. Luckily though, the Broadcasting Complaints Commission ruled that Power and her employer, radio station Newstalk, were infringing the privacy of the civil servants concerned. Half of the six complaints against Power came from civil servants working in the area of health.

Last week in Northern Ireland, the report on the deaths of the McElhill family in a house fire at Omagh last November was published. Journalists in the Republic quite rightly asked a series of penetrating questions. However, the report on the deaths of the Dunne family in Monageer, Co Wexford, who also died in a house fire 15 months ago, has been delayed because of fears about infringing the libel laws.

In Cork, Simon Coveney TD had to use the Freedom of Information Act to obtain a 2002 report which stated that there were "high risks" of air pollution from a toxic waste dump. The media response to the Haulbowline story has been remarkably muted.

If a similar report on Sellafield had been discovered about "high risks" emanating from that plant, it is doubtful that we would have been so shy. Never mind: the glamorous environmental campaigner, Erin Brockovich, is coming to help the Haulbowline campaigners in September.

With Erin and the new health boards, we'll probably do okay.