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HSE changes show centralisation is failing – Ó Caoláin

3 July, 2008 - by Caoimhghín Ó Caoláin TD

Commenting on the proposed changes in the structure of HSE management, Sinn Féin Health & Children spokesperson Caoimhghín Ó Caoláin TD said it showed that the highly centralised approach of the Government and HSE management to healthcare delivery is failing. Democratic accountability and policy change are needed for real reform to take place, he stated.

Deputy Ó Caoláin said, "The proposed changes in the structure of HSE management are, in effect, an admission that the highly centralised approach of the Government and of the HSE to the direction and the delivery of healthcare services is failing. They were warned that this would be the case when the HSE was first established but the Government refused to listen.

"We have a centralised bureaucracy managing services from on high, remote from delivery on the ground. Healthcare workers regularly report lack of clarity and confusion of leadership at the lower levels of the management structures. This has adversely affected morale in the service and the delivery of care to patients.

"Parallel with this highly centralised management approach is the dogma of centralisation of virtually all hospital services in a handful of centres. Even as the HSE announces its management changes it is proceeding apace with the slashing of services in local hospitals throughout the State.

"Simply regionalising management structures is not enough. Health Minister Harney, with the full backing of her Government colleagues, has insulated herself from accountability. She hides behind the HSE but it is her and her colleagues' flawed policies that pull the strings. These changes provide for no democratic accountability at State or regional level.

"Democratic accountability for the management of publicly funded and publicly provided health services must be restored to the Oireachtas and to communities at regional level. The Regional Health Forums are little more than talking shops and should either be given real powers or abolished altogether.

"No amount of management change can compensate for flawed policy and the health policy of this Government is deeply flawed. It has reinforced the two-tier public-private system and is undermining the public health system with its drive to privatise and centralise. Real reform demands real policy change." ENDS

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