1

Health Service Reform:Implications for the

Disability SectorPresentation to NFPBA

25th July 2005

James O’GradyNational Manager for Disability Services

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Health Board Structure1970 - 2004

• The health board system had a number of key features:

–Complex and fragmented structure

–Lack of standardization and coordination across system

–Local decision-making and involvement

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Need for Health Service Reform Programme

• A number of reports were major drivers of the reformed health system:

–Brennan Report

–Prospectus Report

–Hanly Report

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Need for Health Service Reform Programme

• Need to streamline and consolidate fragmented system

• Demarcation of roles between policy arm and executive arm of health service

• Enhanced lines of accountability• More integrated Human Resource, Information

Communications Technology & Finance functions

• Need for continued emphasis and focus on consumer needs

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CEO

Office of CEO

Communication

Service

Governance

Director of PCCC

Director of NHO

Director of HR

Director of Finance

Director of

Shared Services

Director of CMOD

Director of ICT

Director of Population

Health

Director of Corporate

Affairs

Structure and Functions of HSE

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Structure and Functions of PCCD

Director PCCC

Asst. Director- Contracts

Asst. Director – Planning, Monitoring &

Evaluation

Nat. Care Group Manager –

Primary Care

Nat. Care Group Manager

– Children & Families

Nat Care Group

Manager - Disabilities

Nat. Care Group

Manager – Older People

Nat. Care Group Manager –

Chronic Illness

Nat. Care Group Manager –

Mental Health

Nat. Care Group Manager – Social

Inclusion

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Structure and Functions Of PCCD

Director of PCCC

Asst. Director -

West

Asst. Director – Dublin/NE

LHO LHO LHO

Asst. Director -

South

Asst. Director – Dublin/ ML

LHO LHO LHO LHO

LHO

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Structure and Functions of National Disabilities Care Group

Nat. Manager of Disabilities Care

Group

Director of PCCC

Asst. Directors – Regions:

West

South

Dublin/North East

Dublin/Mid Leinster

Local Health Office

Local Health Office

Consultative Fora

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PCCC Model• PCCC model will be person centred, with

following key elements:– Strong national direction regarding

implementation of policy and planning– Devolved local decision making with regard

to service delivery– Regional co-ordination to ensure

consistency of approach– Individual service user, their families and

communities involved in planning & design of services in their area

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PCCC Model

• Primary Care Teams will form substantial basis of PCCC delivery

• Some Care Groups e.g. Disabilities, Children & Families, Mental Health and Older People contain significant element of specialist need and provision

• Design of final structure and processes should reflect this feature

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Disability Strategy 2004

• Disability Strategy 2004 comprises Disability Bill, Education for Persons with Special Educational Needs, Act and Sectoral Plans of 6 government departments

• Disability Strategy will appreciably influence targeting of resources in future

• Disability Strategy will involve allocation of dedicated multi-annual funding over next 5 years

• Will also shape future design of service delivery• Dedicated PCCC structure will be in place to effect

delivery of Disability Strategy

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Challenges• How to ensure inclusion of service

users and families in service design

• Development of alternative models of service delivery

• Review of framework for service design & provision, including further enhancement of consultative fora

• Development of strategic alliances with statutory and community bodies

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Transitional Commitments

• Regional Consultative Committees will be retained in present form until end 2006

• HSE commitment to existing levels of service delivery

• Development funding for 2005 will be implemented in the coming month