1. 1 Health Service Reform: Implications for the Disability Sector Presentation to NFPBA 25 th July 2005 James O’Grady National Manager for Disability Services

2. 2 Health Board Structure 1970 - 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

3. 3 Need for Health Service Reform Programme A number of reports were major drivers of the reformed health system: –Brennan Report –Prospectus Report –Hanly Report

4. 4 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

5. 5 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

6. 6 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

7. 7 Structure and Functions Of PCCD Director of PCCC Asst. Director - West Asst. Director – Dublin/NE LHO Asst. Director - South Asst. Director – Dublin/ ML LHO

8. 8 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 Consultative Fora

9. 9 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

10. 10 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

11. 11 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

12. 12 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

13. 13 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