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Health Service Executive (Governance) Bill 2012: Report Stage (Resumed) and Final Stage (Continued)

Wednesday, 12 June 2013

Dáil Éireann Debate
Vol. 806 No. 2

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Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am sorry the Deputy does not agree. We are in complete agreement on the need to send a strong message on mental health. This is the first time there will be a separate and distinct post of national director of mental health in the HSE. The person who has been appointed on a director-designate basis will be responsible to the director general for the budget and resources applied to mental health and for advancing the Government's stated policy of implementing A Vision for Change.

I remind Deputy Ó Caoláin that a key purpose of the Bill is to abolish the board structure and replace it with a directorate model. The directors are to be employees to ensure that their focus is on operational responsibility and accountability. Any new employment competition will be run in accordance with Public Appointments Service processes. The past tense to which the Deputy alludes is of no particular significance. I am not prepared to accept the amendment and, respectfully, I ask the Deputy to withdraw it.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I will not persist in addressing the matter. Certainly, I will have an opportunity to address some of the salient points in the next grouping, which includes amendments Nos. 3 and 4. I am not happy to withdraw the amendment, however. I welcome wholeheartedly and without hesitation that a director of mental health appointment has been confirmed, which is hugely important. The other steps, however, would have been hugely important and that importance is not lessened by the fact of the director of mental health appointment. The need is for certainty into the future, which is always important. As one never knows who might be in office at any point in the future, let us guarantee it now. It is a legacy the Minister could leave by taking on board amendment No. 2.

  Amendment put and declared lost.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Amendments Nos. 3 and 4 are related and may be discussed together.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I move amendment No. 3:

In page 6, line 30, to delete "greater than 6" and substitute "greater than 8".

Currently, the Bill provides that the directorate, which will be the governing body for the HSE, will consist of the director general and not more than six other members, who are referred to in the Bill as "appointed directors". Only HSE employees at the grade of national director or no less senior grade will be eligible to be appointed as directors. The decision to include employees in no less senior grades was the result of a Committee Stage amendment I introduced. Amendment No. 3 will give practical effect to that provision by making provision in respect of the size of the directorate. The HSE has recently appointed people to head up key service areas, including a national director of mental health, a national director of hospitals, a national director of primary care, a national director of social care and a national director of health and well-being. I have always made it clear that my intention is that employees in charge of key service areas will be members of the directorate. It is also my intention that the person heading child and family services will be a member of the directorate pending the introduction of the new child and family support agency. As I stated on Committee Stage, however, the governing body of the HSE should have scope to encompass other very significant people in the HSE. I propose amendment No. 3, therefore, to increase the maximum number of appointed directors from six to eight. This will allow relevant service heads and a small number of other key senior employees such as the chief operations officer and the chief financial officer to form the governing body of the HSE. I assure Deputies that there will be no additional cost associated with the making of this amendment.

  Having set out my reasons for increasing the maximum size of the directorate, I turn to amendment No. 4, proposed by Deputy Ó Caoláin, which is grouped with amendment No. 3. However, I do not want to second-guess what the Deputy may say. While amendment No. 4 relates to the composition of the directorate also, its effect would be to have no requirement that members of the directorate be drawn from among employees in senior management positions in the HSE and no requirement that the directorate need necessarily have any HSE employee on it. This would not fit with one of the central policy objectives underpinning the Bill, which is to abolish the board structure of the HSE, the members of which are traditionally drawn from outside persons, and replace it with a directorate the members of which come from senior management in the executive. The directorate structure reflects the need for greater operational management focus on the key delivery of services and greater transparency in the funding of service delivery and accountability. Deputy Ó Caoláin's amendment envisages outside persons being appointed to the directorate, which is consistent with a board structure rather than a directorate model. I hope the Deputy understands why I do not propose to accept the amendment.

  However, I make clear that the intention is that appointed directors are drawn from HSE employees irrespective of when the person was appointed to his or her grade. Separate from the Bill, but as part of the overall policy underpinning it, new senior HSE posts were approved. A Public Appointments Service competition was held to fill the new posts. The director general designate of the HSE announced on 17 May 2013 that the Public Appointments Service had concluded a recruitment process on behalf of the HSE for five new national directors and a chief financial officer. It is my intention that people recruited under the competition will be appointed to the directorate.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I record my support for amendment No. 3.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I thank the Deputy.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin We get off to a positive start on the grouping, at least. The words used in the amendment are "not greater than" which means the Minister is not locked into making eight appointments. He is not locked in to a maximum of six appointments either but has flexibility in other areas of importance which must be reflected in the make-up of the envisaged directorate. That is good to go and I will support it.

Amendment No. 4 is not about demanding that the membership of the directorate is made up of people outside the Health Service Executive. It is about having the option of appointing - I repeat - the best possible people to take on these roles of responsibility. I emphasise that these are responsible roles. Next to the Minister's own role, the members of the directorate will have the responsibility of oversight of the single largest swathe of public moneys expended annually. It is a phenomenal responsibility. While I have no issue at all if all appointments are made from within the service and expect that many if not all will be, I am concerned that the door is closed. It is strange because only in the last number of days, we have heard that serious consideration is being given to the idea of ministerial appointments from outside the elected make-up of the House. The issue has been reflected on over the course of the weekend gone by and in other fora. There is precedent for it. This is about circumstances in which someone presents who can bring an expertise to bear. Clearly, he or she is not going to come from a background which is not associated with or reflective of the roles and responsibilities with which he or she would be entrusted as a member of the directorate. He or she would come from a background in health. There are many precedents, including precedents in other Departments, where appointees have not come through the respective departmental strata but have been brought in from within the citizenry of the State and beyond. It is something we should always leave open to consideration, which is all the amendment seeks to do.


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