Dáil Éireann - Volume 393 - 15 November, 1989

Ceisteanna—Questions. Oral Questions. - Future of Health Boards.

10. Mr. Allen asked the Minister for Health if he will make a statement on the future of the health boards.

Dr. O'Hanlon: As the Deputy will be aware, the recently published report of the Commission on Health Funding has made recommendations about the future administrative structure of the health services. Following publication of the report, I have commenced a process of consultation with all the major interests and institutions in the health sector on the commission's various conclusions prior to formulating proposals for Government.

Mr. Allen: It is obvious the Minister is still frozen into inactivity and indecisiveness. Will he agree that the health boards have outlived their usefulness, are over-bureaucratic and cannot deal with problems in the health services? Has he changed the opinion he had during the election campaign when he said that the health boards were inadequate?

Dr. O'Hanlon: As Minister both during the election campaign and now I have an open mind on the health boards. It is important that we should not change for the sake of change. Whatever changes are brought about must be in the interests of the patient who must be the central and focal point. Against that background we will be looking at what structural changes are necessary following consultation with all the various interested parties.

Mr. Spring: As the Minister for Health has informed us that he has an open mind in relation to the health boards and as he is now in his third year as Minister for Health, has he formulated a view on whether health boards have outlived their purpose? If he is having consultations [494] would he consider having some consultations with Members of the House who would be in a position to tell him how health boards work or do not work as the case may be?

Dr. O'Hanlon: To take the second point first, there will be an opportunity this evening on the Supplementary Estimate——

Mr. Howlin: Fifteen minutes.

Dr. O'Hanlon: ——Deputies could say a lot in 15 minutes. There will be an opportunity for Members to give their views on both the Commission on Health Funding and on health boards. As regards the health boards I have stated on many occasions that there are areas within the health boards where it is necessary to look at the structures and where change may be necessary. In regard to the health boards themselves I have an open mind.

Mr. Yates: Would the Minister acknowledge that the standard of health care throughout the country varies very much within each of the eight health boards? Because of varying subventions facilities such as speech therapy, community care services, hospital services, the ambulance service and so on, vary considerably depending on what part of the country one resides. It is very unfair and on the basis of service to patients, that alone is a reason for changing the structures.

Dr. O'Hanlon: In general we have an excellent health service throughout the country and one of which we can be justifiably proud. Certainly, there are gaps in the service. There are variations in some areas and I would say some of the variation is not the fault of the executives of the health boards but of the members.

Mr. Yates: It is the fault of the Department.

Mr. Howlin: It is the Minister's fault.

[495] Dr. O'Hanlon: It is the fault of the members who walked away from their responsibilities in the Southern Health Board. We have some of them here who walked away and would not agree with the amount allocated to them in the budget.


Mr. Sherlock: I would remind the Minister that in rejecting that earlier budget the health boards were proved right, because he had to provide an extra £1,090,000.

The health committees are part of the structure of the health boards as set up under the Health Act, 1970, and under that Act were given advisory powers. Health boards are required by statute to accept the advice of the health committees. Health committees have been in limbo since 1970 when the Minister wrote to health boards saying that responsibility would be taken over by the health boards. Would the Minister now state what the position is likely to be in the future in regard to the health committees which were set up under the Health Act, 1970?

Dr. O'Hanlon: The Deputy is right when he says the health committees are no longer in existence, although I understand they are functioning in a voluntary capacity in some health board areas and that they are advisory committees. The health boards now have statutory responsibility for this service. What I find interesting is that Members of the Opposition, and particularly those from Fine Gael, are going around the country asking that the health committee be brought back and at the same time coming into this House and saying——

Mr. Yates: My position is very clear.

Dr. O'Hanlon: ——that health boards should be done away with. That is happening in every county in Ireland.

Mr. Allen: I am amazed at the Minister's response having been frozen into [496] inactivity for two years while the commission were sitting. Is the Minister now saying he will do very little about the crisis in the health boards and in the health service until he has consulted with all the parties, many of whom have a vested interest against any change, including some of his own profession?

An Ceann Comhairle: I am afraid we are not proceeding by way of questions.

Mr. Allen: How long will we have to wait before we have real decisions?

Dr. O'Hanlon: The commission on health funding reported only a couple of months ago. We have initiated discussions with various groups and when those discussions are complete, I do not think that will take very long——

Mr. Howlin: The Minister will set up another committee.

Dr. O'Hanlon: We are not making change for the sake of change. The changes which are necessary will be made but they will be patient orientated to ensure that whatever changes are made will be in the best interests of patient care. I do not accept that there is a crisis in the health service, but we have always acknowledged that there are gaps. If you go to other western countries you will find that our service compares very favourably.

Mr. Allen: The Minister found out about the crisis during the election campaign.