Cabinet approval was announced this week for the Health Service Executive to implement a new Health Regions plan - of six separate divisions - that will see Mayo now form part of a new division - HSE West and North West. As to whether this will mean Mayo's voice at the table will be heard stronger than ever, in terms of the delivery of health and social care services, remains to be seen.
The new HSE West and North West division will include counties Donegal, Sligo, Leitrim, Roscommon, Mayo and Galway - whereas the functional area of the existing model - Regional Health Forum, West - covers the city councils of Limerick and Galway and the county councils of Clare, Donegal, Galway, Leitrim, Limerick, Mayo, North Tipperary, Roscommon and Sligo. On paper, the new structure should result in less councillors attending the monthly public health meetings to campaign on local health matters.
Up to now, health forum meetings have generally been held at Merlin Park Hospital in Galway, consisting of 40 public representatives. However, such a set-up has regularly proved unwieldy and excessively wide-ranging, with meetings lasting for hours on end, following a question-and-answer procedure that often leaves members waiting for local representatives from counties hundreds of miles away to have their say.
It has also to be clarified whether the health forum meetings will continue under the new structure. What is known so far, is that Minister for Health, Stephen Donnelly, approved the plan this week, that new Regional Managers on salaries of €250k+ are to be appointed, and that the new health Regions will commence operation from February 2024, 'with further reforms and devolution of authority to take place on a phased basis through 2024 and 2025'.
HSE Health Regions are currently known as Regional Health Areas, with Mayo coming under the auspices of Regional Health Forum West, which covers the city councils of Limerick and Galway and the county councils of Clare Donegal, Galway, Leitrim, Limerick, Mayo, North Tipperary, Roscommon and Sligo.
The forum holds public meetings approximately seven times a year, generally at a meeting room in Merlin Park Hospital in Galway, and includes 40 members from across the various local authorities, as well as management and executive and staff.
Mayo members on the existing forum include county councillors Michael Kilcoyne Ind, John O'Hara FG, Blackie Gavin FF and Martin McLaughlin FF.
Previously, Mayo was represented on what was formerly known as the Western Health Board, which was dissolved following a restructuring of health services, which changed over to the HSE in 2005.
The new Health Division West and North West will cover counties Donegal, Sligo, Leitrim, Roscommon, Mayo and Galway and the implementation of the overall HSE Health Regions plan will entail the internal reorganisation of the HSE into six operational regions. The changeover in structure is scheduled to take place early next year and once set up, the existing HG and CHO structures in the health service, are also to be stood down.
While full details of how the new divisions will work has yet to be advised, the HSE did reveal that new management posts are to be created to oversee the revised structures, stating: "A first step in the transition to Health Regions is the appointment of Regional Executive Officers (REOs ). Each REO will be the accountable officer at Health Region level, responsible for the delivery of high-quality, safe, and accessible services for the population of their region. Sanction to proceed with the recruitment of these senior leadership posts has now been approved. The posts are to be advertised within weeks, with salaries linked to the pay under the new public only hospital consultant contract – up to €257,000."
Outlining the health division plan, the HSE added: "The coordination and delivery of health and social care services along regional lines aims to facilitate more integrated care for patients and those who use our services across the country. It also aims to enable a coherent population-based approach to service planning and delivery, where care is planned and funded in line with people’s needs at regional and local level."
Minister for Health Stephen Donnelly TD added: "The Plan sets out the pathway and key actions to bring these six new Health Regions to life in the immediate months ahead. While the transition represents a considerable change to organisational structures, it is important to note that structural change is not the primary objective of this reform. These new arrangements aim to improve the health service’s ability to deliver timely, integrated care to patients and service users, planned and funded in line with their needs."
Bernard Gloster, Chief Executive Officer of the Health Service Executive (HSE ) and Co-Chair of the Sláintecare Programme Board, added: "These changes aim to ensure that when we give health services to our citizens that we do it in a joined-up way via GPs, community services, nursing support, social care services and acute hospitals as needed. The idea behind reorganising our structures is to ensure that people experience just one health service, providing whatever care they need at the right time and in the right place. When we talk about ‘integrated care’, this is what we mean. In line with the introduction of health regions, I am currently finalising plans for a changed HSE centre and this will add to the overall improvement in governance and leadership of the health service.”
The HSE Health Regions Implementation Plan can be found at: https://www.gov.ie/en/publication/4eda4-slaintecare-regional-health-areas-rhas/#hse-health-regions-implementation-plan
