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‘HSE not fit for purpose’ – Dr. Harty

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Former Health Minister, Dr. James Reilly has been criticised by Clare TD Dr. Michael Harty who he said disbanded the HSE board in 2012 on a whim.

Spaking in the Dáil on the Health Service Executive (Governance) Bill 2018 which he said will reconstitute the board and introduce real structural health reform, the Independent TD stated. “A Programme for Partnership Government published in May 2016 which underpinned this Government included a commitment to continue to dismantle the HSE and replace it with a new structure. Thankfully, that new structure has not appeared. In the Oireachtas Joint Committee on Health’s deliberations on Sláintecare we were advised by many experts in change management that if we were to reform our health service, we should do so with the minimum structural change possible because once major structural changes are made, it takes years to implement them. The recommendation was to reconstitute the HSE board and work from within the HSE to reform the health service, rather than setting up a new body.

“The report made an important recommendation, which I hope the Minister will progress, to decentralise the HSE, not down to health board level but to regional bodies where the hospital groups and community health organisations would be merged. These merged entities would have one budget and the independence to deliver services in their respective region as the regions need these services. As such, we would not have the unwieldy centralisation that we have in the HSE at the moment. I hope the appointment of a HSE board is the start of that process,” Dr. Harty added.

Harty maintained health reform has been stalled by to alterations to health management structures. “We have seen how chopping and changing in our health management structures has inhibited real health reform. It has resulted in chaotic and fragmented health services. It allows for excellent and adequate care in some areas but unfortunately there are many areas in our health service that are extremely stressed and do not deliver optimum care. We have incoherent policies and a management structure that is almost impossible to navigate. We are all aware of the problems with our waiting lists. Trolleys are just a symptom of wider problems within our health service. We know trolley numbers will vary from one period of a year to another. If there is only one person on a trolley, it is an indication we have capacity issues with regard to staff and beds.

“The present structure of the HSE is not fit for purpose. The management processes were put in place with 18 clinical directorates and a group of civil servants who must have had a conflict of interest in being civil servants and members of the board. The system became completely unwieldy and not fit for purpose. It was intended to be a temporary arrangement initiated by the then Minister, now Senator James Reilly, while he put some other structure in place. We were never quite sure what that structure would be. The replacement structures, which are not fit for purpose, are still there seven years later. That system has inhibited health reform, integration and structural reform in our health services,” Dr. Harty said.

Meanwhile, Mike Taylor who is seeking a Fine Gael nomination in the Kilrush area for the 2019 local elections has called on Harty to bring the Board of the Coombe Womens and Infants University Hospital before the Dáil’s Health Committee. “In light of what was raised on the floor of the Dáil by Deputies Coppinger and Smith, I want to call on Michael Harty as Chairman of the Health Committee to request that the Board and Master of the Coombe are called before the Committee at the earliest instance”.

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