Health Service Executive
|Feidhmeannacht na Seirbhíse Sláinte|
|Publicly funded health service overview|
|Formed||1 January 2005|
|Preceding Publicly funded health service|
|Headquarters||Dr. Steevens' Hospital, Dublin 8, Ireland|
|Annual budget||€13 billion|
|Publicly funded health service executives||
|Parent department||Department of Health|
The Health Service Executive (HSE) (Irish: Feidhmeannacht na Seirbhíse Sláinte) is responsible for the provision of health and personal social services for everyone living in Ireland, with public funds. The Executive was established by the Health Act, 2004 and came into official operation on 1 January 2005. It replaces the ten regional Health Boards, the Eastern Regional Health Authority and a number of other different agencies and organisations. The Minister for Health has overall responsibility for the Executive in Government. The HSE is Ireland's largest employer with over 67,000 direct employees, and another 40,000 in funded health care organisations. It has an annual budget of over €13 billion, more than any other public sector organisation.
The HSE is a large organisation of over 100,000 people, whose job is to run all of the public health services in Ireland. The HSE manages services through a structure designed to put patients and clients at the centre of the organisation.
The HSE Code of Governance provides an overview of the principles, policies, procedures and guidelines by which the HSE directs and controls its functions and manages its business, it is intended to guide the Directorate, leadership Team and all those working within the HSE and the agencies funded by the HSE, in performing their duties to the highest standards of accountability, integrity and propriety.
The HSE Code of Governance was first approved by the Minister for Health and Children in 2007. The Code has been reviewed and updated in line with best practice and to ensure it meets the requirements of the Code of Practice for the Governance of State bodies (2009). The revised Code was approved by the Minister for Health in December 2015.
The HSE has four Regional Health Forums, which includes representatives from the city and county councils within that area.
The HSE's organisational structure is divided into some key areas:
- Integrated Services, which includes services delivering care in the community and acute hospital and ambulance services
- Quality and Clinical Care, which provides clinical leadership, national clinical services and quality and performance programmes
- Support Services, HR, Finance, Communications, Estates and ICT, which enable the HSE to function efficiently and cost effectively.
- Mr. Tony O'Brien, Director General of the HSE
- Mr. Stephen Mulvany, Chief Financial Officer & Interim Deputy Director General
- Mr. John Connaghan, Deputy Director General, Chief Operations Officer
- Mr. Dean Sullivan, Deputy Director General, Chief Strategy and Planning Officer
- Dr. Philip Crowley, National Director Quality Improvement
- Ms. Rosarii Mannion, National Director HR
The HSE delivers its services through fifty public hospitals and thirty-two local health offices nationwide. The HSE is divided into four regions:
- HSE Dublin Mid-Leinster – (County Kildare, County Laois, County Longford, County Offaly, County Westmeath, County Wicklow and South Dublin)
- HSE Dublin North East – (County Cavan, County Louth, County Meath, County Monaghan and North Dublin)
- HSE South – (County Carlow, County Cork, County Kerry, County Kilkenny, County Waterford, County Wexford and South Tipperary)
- HSE West – (County Clare, County Donegal, County Galway, County Leitrim, County Limerick, County Mayo, County Roscommon, County Sligo and North Tipperary)
Each region is headed by a Regional Director of Operations, who is responsible for managing all services in that area.
News and criticism
The HSE is the subject of daily news reporting. The HSE is working to modernise and improve how healthcare is delivered in Ireland, through the extension of the amount of care provided in the community, rather than in hospital, and also through the initiation of a wide range of clinical programmes. These clinical programme are led by hospital consultants, and are going to standardise the approach to our most grave and common healthcare challenges, like heart disease, diabetes and others.
The HSE is frequently portrayed by the Irish media as an inefficient, top-heavy and excessively bureaucratic organisation. The Irish health system has been involved in a number of serious health scandals, for example relating to cancer misdiagnoses in 2008. The HSE has also been the subject of criticism for cutbacks, service cancellations etc., but has recently indicated that it is making good progress in saving costs and achieving its required 'break-even' budget position for 2010.
In March 2010, it emerged that 58,000 X-rays had not been reviewed by a consultant radiologist. An independent report into this incident at Tallaght Hospital was published by the HSE during October 2010.
In the same month, the Irish Medical Organisation stated that patients awaiting a HSE medical card were waiting up to six months to receive their card, and that their health was being put at risk as they could not afford medicines that they would have otherwise obtained had they received their card. The HSE has since announced a new online system for medical card applications that will reduce turnaround time for routine applications to 15 days.
In May 2011, key forensic evidence in up to 25 sexual-assault cases may be challenged in court because of a major administrative blunder by the HSE. The victims – some as young as 14 – were told by Gardaí about the incident, in which a nurse who carried out their forensic tests was unregistered. This could lead to the evidence being challenged.
In May 2018, in the midst of the CervicalCheck misdiagnoses controversy, Tony O'Brien announced his resignation as director-general of the HSE with effect from close of business on 11 May.
- "Department of Public Expenditure & Reform - Databank - Public Service Numbers". Department of Public Expenditure & Reform. Retrieved 8 January 2017.
- "Family demands HSE apology over misdiagnosis". The Irish Times. 22 September 2008.
- "Up to seven families to be contacted by HSE". RTÉ.ie. 1 April 2008.
- "HSE progress is slow but more patients are not waiting longer". SaraBurke.com.
- "HSE confirms investigation into Tallaght x-ray scandal". Breaking News. 3 October 2010.
- "Major delays with medical card scheme". RTÉ.ie. 22 March 2010.
- "Archived copy". Archived from the original on 30 August 2010. Retrieved 2010-10-08.
- Kelly, Fiach; McDonald, Brian (12 May 2011). "Blunder by HSE puts up to 25 rape cases in doubt - Independent.ie". Independent.ie. Retrieved 2018-01-14.
- "HSE boss Tony O'Brien steps down in wake of CervicalCheck scandal". Irish Independent. 10 May 2018. Retrieved 12 May 2018.
- "HSE chief Tony O'Brien to take leave of absence from US board". Irish Times. 3 May 2015. Retrieved 12 May 2018.