HEALTH FORUM CALLS FOR ACCOUNTABLE AND EFFICIENT HEALTH SERVICE

At its meeting in Galway this week the Regional Health Forum West adopted a motion proposed by Cllr Declan Bree, calling on the Government to provide a health service that is democratically accountable and efficient and capable of delivering universal access to quality healthcare.

Speaking to the motion Cllr Bree said, “When the Government created the HSE it clearly and deliberately created a vehicle to implement Government policy, a vehicle that is run by faceless bureaucrats drawn from all parts of the country, who appear to be answerable to no one but the Minister for Health.

“When the regional health boards existed details of budgeting and proposed changes in services were brought before the members of the Health Board and considered and voted on.

“This was an open and transparent system where elected representatives and representatives of medical staff and nursing staff and others had the opportunity of debating important matters with senior management, and of voting on plans that would affect the future of medical services in their respective region - and of course this was all covered by and published in the local media.

“The staff of the Health Boards were accountable to the members of the board and the elected councillors on the health boards were in turn accountable to the people who elected them to office.” said Cllr Bree.

“However in the period since the Government abolished the Health Boards and established the HSE, openness, transparency and public accountability have become a thing of the past. Democratically elected T.D.’s and Councillors have been sidelined.

“The senior management and bureaucracy in the HSE appear to be accountable to no one other than the Minister.

“We know that over the past number of years that the number of higher and middle management in the health services have increased dramatically.

“In the year 2000 there were six Grade VIII officials in the health service, by 2006 that had increased to 602, an increase of 9,843%. The number of Grade VII’s increased from 496 to 917, an increase of 118%. The number of Grade VI’s increased from 484 to 1,014 an increase of 106% and the number of Grade V’s had increased from 663 to 1,484, an increase of 124%.

“In the most recent report of the Review Body on Higher Remuneration when it referred to pay levels for managers in the HSE including National Directors, Assistant National Directors, Hospital Network Managers, Directors of Regional Health Offices and Managers of Local Health Offices, the review body found it difficult to work out what these officials should be paid because it couldn’t figure out what precisely many of them do and who they report to. And I must admit I can’t figure out what many of these officials do.” said Cllr Bree.

“With the exception of people like Dr Sean Conroy and his staff who service this Forumit has been my experience in the period since I became a member of the Forum that many senior HSE officials feel they are answerable to no once and that they can do as they wish. On numerous occasions I found that my correspondence to them was ignored. When I asked legitimate questions relating to the health services senior officials refused to answer the questions. In fact last year I had to request the Office of the Ombudsman to intervene in order to elicit a response from one of these senior officials. The notion of democratic accountability is foreign to many of these people.

“In the period since this Regional Health Forum was established we have had numerous and well considered discussions and debates relating to the state of the health services in this region. We have adopted many motions and made many recommendations relating to the improvement and development of the health services and copies of all these motions and recommendations were forwarded to Professor Drumm, and the Health Service Executive.

“However to date we still have not had a response from the HSE to any motion or recommendation adopted by this Health Forum. As I said to Professor Drumm at our September meeting, it would appear that when they reach the Health Service Executive in Dublin they are placed in a filing cabinet never to be seen again.

“The Governments decision to hand over day to day control of the health services to the HSE was deliberate and it is now obvious that the Government and Minister Harney are hell bent on implementing an agenda that favours private medicine at the expense of our public health service. They are clearly responsible for creating the present crisis in the provision of health services.” Cllr Bree said.

Cllr Bree then proposed the following motion which was adopted by the Forum: “That the Regional Health Forum West deeply concerned with the HSE’s lack of democratic accountability, and further concerned at the growth of the two-tier health system, and further recognising the inability of the HSE to provide a universal high quality health care service to the people of this country, calls on the Government to provide a public health service that is democratically accountable and efficient and capable of delivering universal access to quality healthcare.”