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Radical reform: Ireland’s healthcare system to be divided into six regions

Minister for Health Simon Harris confirmed that cabinet gave the go-ahead for the six new regional health bodies


(Lynne Cameron/PA)

(Lynne Cameron/PA)

(Lynne Cameron/PA)

Ireland is to see “radical reform” of the health sector, after cabinet approved plans to split the service into regional divisions.

Minister for Health Simon Harris confirmed that cabinet gave the go-ahead for the six new regional health bodies at a meeting on Wednesday morning, before a formal announcement in the afternoon.

The six regional health bodies are to deliver “people-centred” health and social care, with their own budget based on local population needs, deprivation factors, age and other factors based on the health of residents.

The goal of the plan is that the majority of care will be delivered in the community and not in acute hospitals.

The proposed regions will be based on population data, averaging at around 50,000 people, lettered Area A through to Area F – however, patients can choose to be treated elsewhere if they wish.

While the HSE will continue to be the central executive with responsibility for planning and strategy, regions will have greater autonomy to make decisions at local level, including budget allocation, a “one budget, one system” approach, a move the minister said would “improve accountability and transparency”.

The minster spoke at length about “radical reform in the delivery of healthcare”, “a new direction” and that “the HSE as currently constructed will not continue”.

He went on to deride opposition leader Micheal Martin’s former tenure as health minister, saying the HSE in how it was set up and as it stands “is not workable”.

Both the minister and CEO of the HSE Paul Reid says there will not be more managers, but a more “streamlined national centre” which will avoid duplicating personnel. However, the final structure of the organisations has not yet been decided on, and it is not known how many personnel may be lost after services are amalgamated.

In terms of price, “there is no cost expected in this initial step of the process”, the Government statement said, but later adds: “The establishment of new regional bodies will require an organisational change programme which will require investment.”

Mr Harris said: “This is a key day for the delivery of Slaintecare and for the reform of our health service.

“Today’s announcement identifies the six regions which will be used in developing structures for the delivery of integrated care.

“This will result in clear financial and performance accountability, empower frontline staff and devolve authority from the HSE to the local regions.”

The new health areas are in line with recommendations made in the Oireachtas Committee on the Future of Healthcare Slaintecare Report (2017), that regional bodies should be responsible for the planning and delivery of integrated health and social care services.

Stakeholders in each of the areas will be invited to contribute to the design of the services.

Work will also now be undertaken to detail the national and regional organisational design which will be brought back to Government for approval within 12 months.

The regions, and each of their budgets will come into effect in 2021.