| Health Board |
Article Index for Health |
Website Links For Health |
Information About ™Health Board |
| CATEGORIES ABOUT HEALTH BOARD | |
| healthcare in the republic of ireland | |
|
On January 1, 2005 the health boards where replaced by the Health Service Executive , although the system is still in a transition phase. BACKGROUND Prior to the advent of the health board system the Health Act, 1947 was the principal legislation on the states role in the provision of healthcare in Ireland; this was the act that served as the legislative basis for the Mother And Child Scheme which later was withdrawn under church and doctor opposition. Under the 1947 act the ''health authority'' for a functional area was the City Council or County Council of that area. This reflected the fact that until 1947 the Minister For Local Government & Public Health was responsible for Public Health , and in that year the Minister For Health was created as a separate ''Minister of the Government'' by the Ministers and Secretaries (Amendment) Act, 1946 . In 1970 the healthcare system of Ireland was still very much a private and voluntary system with the Catholic Church still retaining effective control of healthcare, in particular the ownership of hospitals and institutions. Doctors served very much in a Sole Trader capacity with the state taking few responsibilities beyond the organisation of the provision of healthcare to the disadvantaged. THE HEALTH BOARDS In 1970 the Health Boards Regulations, 1970 where made under the Health Act, 1970 and it defined among other things the functional area, membership and composition of the board of each health board. Each health board was headed by a Chief Executive Officer and more often assisted by an ad-hoc management team consisting of professionals who where Public Servants . :†In 1990 the functional area was changed to explicitly include the status on January 1, 1986 and thus the need for representation on the health board which had continued to be de-facto responsible for health within the city in the interim period. Reforms of 1999 In the late 1990s the counties of Dublin, Kildare and Wicklow represented almost half of the population of the state and had only one health board, the ''Eastern Health Board''. The rest of the state served by seven health boards, each with a designated functional area. The Health (Eastern Regional Health Authority) Act, 1999 was introduced and dissolved the Eastern Health Board and created four bodies in its place, thus bringing to eleven the number of regional health authorities and boards. The ''Eastern Regional Health Authority'' (''ERHA'') was given overall responsibility for the former health board functional area, however the actual provision of services was delegated to three ''area health boards''. These area health boards where; the ''Northern Area Health Board'' (''NAHB''), ''East Coast Area Health Board'' (''ECAHB'') and the ''South-Western Area Health Board'' (''SWAHB''). The functional areas of the area health boards did not correspond exactly to the city and county council boundaries and instead was defined in the First Schedule of the act. The Eastern Regional Health Authority (Area Health Boards) Regulations, 1999 determined the composition of the board of each area health board. The composition of the Eastern Regional Health Authority was determined by the act. CRITICISMS Chief among the criticisms of the health board system was that of Political Patronage . Typically at about half of the board members where appointed by the city or county councils of the functional area; and the Minister for Health appointed three members on each board. The cumulative effect was that over half of the board members where, in effect, appointed by local and national government; the nominated board members where often the aspiring members of political parties. This method of nomination and selection was often accused of being the core problem of the healthcare system; poor accountability and service provision due to the politicised nature of the system which meant that decisions where made on political needs rather than professional teams deciding on medical need and weighing factors like value for money. Additional members where appointed by election by registered Chemist s, Doctor s, Dentist s, Nurse s who practiced in the functional area. The Eleven Kingdoms The term ''the Eleven Kingdoms'' was a term that gained some currency among Journalists , Politicians and the public in the early 2000s before the system was reformed. The Eleven Kingdoms refers to the eleven health authorities and boards which where then in existence. EXTERNAL LINK |
|
|