The Government’s move to remove autonomy over day-to-day spending from several HSE regions represents a significant reversal of healthcare reforms, announced with much fanfare just two years ago, aimed at having decisions made at a more local level.
Only a year or so ago, the six new HSE areas – established under a policy of regionalisation – were given powers over how they spent their budgets.
Speaking at a conference last September, Taoiseach Micheál Martin described the regional structure as “critical” to the overall Sláintecare health reform plan. The changes, he said, had strengthened and streamlined governance and improved delivery.
However, a few months into this year it was clear that financial control problems were emerging in some regions, with expenditure running well in advance of official allocations. There were also claims that some regions had recruited more personnel than officially permitted.
In April, HSE chief executive Anne O’Connor placed three of the regions – Dublin and South East, Dublin and Midlands and the South West – in what is known as “tier three escalation”, which introduced employment controls and greater scrutiny on spending.
