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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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(Speaker Continuing)

[Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin] Removing the restrictive language of subsection 3 on page 6 allows flexibility. That is all it does. It does not lock in the Minister to anything. It is worthy of support for that reason. It is important to those who have given advocacy to this argument. I acknowledge the efforts of Mental Health Reform, which is the backdrop to the argument in this instance. However, amendment No. 4 is not confined to mental health considerations. It could apply to any of the directorate roles within the make-up of the new directorate.

I appeal to the Minister to reconsider his position on amendment No. 4. It is not at variance with the Minister's amendment, No. 3, and the two can work well in tandem. I am supporting No. 3 and the Minister is due to support No. 4.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher We are dealing with this issue again. I have not heard a reason for the Minister's placing of such restriction on a panel of people who are to take on very important roles in the delivery of health care. It is narrowing it to a few people. In recent years, the Government and others have placed emphasis on looking beyond the Civil Service in the delivery of public services and seeking outside expertise and competence. This ties the hands of the Minister drastically in terms of an independent appointments system to assess the criteria of an individual's application so that he or she can be appointed on merit. It cannot be done if the legislation goes through as it is. The provision is in place for no other reason than to provide security and straightforward passage to those who will be appointed to the transformed HSE in a number of years' time. I cannot see the logic of enshrining this measure in legislation as it ties the hands of anyone making a determination on the most suitably qualified person to deliver the onerous task of health care.

From the point of view of the Minister and - I do not mean this in a dismissive manner - whoever is Minister in the years ahead, the purpose should be to appoint the best person on merit. The legislation will not allow that to be done, regardless of who is there at present. These are the only ones who will qualify, although they may be exceptionally bright and talented people. The provision ties the hands of the Minister for the next number of years in terms of appointments. I cannot understand why the Minister would do that.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I thank Deputy Ó Caoláin for supporting amendment No. 3. I cannot accept amendment No. 4 because that brings us back to something more akin to a board than to what is intended. The purpose of this legislation is to establish a directorate that is directly involved in, and focused on, service delivery.

I listened to what Deputy Billy Kelleher said and he is right that we are trying to bring in fresh blood across the system. It is important to remember that this is a temporary structure to get us to the health care commissioning agency, which will be advertised publicly. There is no question of smoothing the way for people to get into that organisation using this route. The Deputy is aware of my criticisms of the formation of the HSE and the amalgamation of 11 health boards, when everyone was promised they could not only keep their jobs but keep the same jobs. We got none of the savings or efficiencies that would normally be expected when amalgamating organisations. One expects greater efficiency through a reduction in staff numbers as there is duplication of function across 11 organisations. This is one of the reasons the hospital groups will be effective. They will do away with much of the fragmentation in the health service and duplication in management and administration, with human resources and management across 49 hospitals decreasing to a system that has management across six hospitals. In addition, there will be a new national paediatric hospital group. I hear what is being said but I regret I cannot accept amendment No. 4.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin It looks as though we do not have a deal. There is no point in dragging this out unnecessarily. I have not heard an explanation of why the Minister of State, Deputy Kathleen Lynch, suggested earlier that the situation was other than what subsection 3 seeks to lock us into, namely, restriction to those in the service and those at particular grade levels. What she put on record in regard to other public service employees is in the past tense and will not be the case once the Bill is enacted. Her contribution was unhelpful and I am concerned at what it intended to do. Whether it was to confuse or to distract I do not know, but I am not happy with it.

Amendment No. 4 is very reasonable and does not take from the legislation. Many people have director roles in different aspects of our public service and the different agencies of government and they were appointed from outside the structures of the entity. There are examples aplenty I could cite that are not akin to boards, as the Minister suggests. The directorate the Minister seeks to put in place will not be weakened by opening it up to the best possible expertise and the greatest energy and enthusiasm, which is necessary. This is particularly true in driving forward reforms in the area of mental health and driving forward the implementation of A Vision for Change, which I acknowledge we are all committed to.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I have covered all the points and, as the Deputy pointed out, we covered this on Committee Stage. No more than the other Deputies, I do not wish to delay the passage of the Bill.

  Amendment agreed to.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin I move amendment No. 4:

In page 6, to delete lines 31 to 36.

  Question, "That the words proposed to be deleted stand", put and declared carried.

  Amendment declared lost.

Acting Chairman (Deputy Robert Troy): Information on Robert Troy Zoom on Robert Troy Amendments Nos. 5 and 12 are related and may be discussed together.

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