Fianna Fáil Health Spokesman Billy Kelleher has expressed surprise that the Minister for Health James Reilly has failed to clear up confusion that has gripped the command structure of the health service.

Deputy Kelleher raised the issue with Minister Reilly in the Dáil this afternoon.

‘There are conflicts between what is being said in the House and what is contained in e-mails from special advisers in the Minister’s Department.  E-mails have been sent from the Minister’s advisers “with the full authority of the Minister”.  The advisers either have the full authority of the Minister or they do not.  They are circumventing the chain of command and now making recommendations to the HSE with the full authority of the Minister.  However, the Minister comes to the House, quotes the Act and claims that they do not have that full authority.  Clearly, the Minister’s special advisers are acting outside their remit when they can send e-mails to Ms Laverne McGuinness, Mr. Pat Healy and the HSE stating they are acting with the full authority of the Minister.

Who is in charge of the health service?  Who is running it?  Do the advisers have the authority to tell the HSE and its managers that they are acting with the full authority of the Minister?  Can the Minister give a “Yes” or a “No” answer?

Minister Reilly responded: “I take responsibility for it [the health service], but it is run by the HSE and there is a chain of command through the Department for policy.”

However Minister Reilly went on to say: “With regard to advisers, if I ask my adviser to pass a message or instruction to an individual in the HSE, I see no issue with this.  It is the same as me picking up the telephone and saying it myself.”

Speaking after the debate Deputy Kelleher said: “The Minister has completely failed to deal with this issue.  The Minister wants to be able to blame the HSE which “runs” the health service but maintain the right to interfere in the running of the health service through third parties.

“The HSE chief executive Cathal Magee and Minister Reilly have clashed over the function of the advisers, their communications and instructions to the Minister and senior HSE management, and the level of their access to and influence on sensitive HSE plans during the summer.  In an email to the department’s secretary general, Michael Scanlon, Mr. Magee raised concern about communications between the advisers and the Minister, and between the advisers and HSE national and regional directors. They were inappropriate, Mr. Magee said, and potentially created “confusion and uncertainty around governance in our system”.

“I was seeking basic answers to simple questions in the Dáil today about accountability.  You cannot have proper accountability if unelected advisers are injecting themselves into the HSE’s chain of command.  Who is senior to whom?  The advisors, or the HSE executives?  The Minister needs to take concrete action to prevent future “confusion and uncertainty around governance in our system” as outlined by Mr. Magee?