Divisional objectives

We acknowledge that this is but a first step towards the development of more refined business plans for each work area. The formulation of these more detailed plans, which will include the identification of the critical success factors, setting performance indicators and indicating what corrective action might be taken in the event of objectives not being reached, will be undertaken over the coming months. These business plans will be essential to the implementation within the Department of the new human resource management arrangements and the devolution of management responsibilities under the provisions of the Public Service Management Act, 1997.

More information on the divisions of the Department is available.

PRIMARY HEALTH CARE

Community Health

Objectives:

• Work towards the introduction of a national cervical screening programme;
• Improve the monitoring and prevention of infectious diseases;
• Achieve 95% uptake in Primary Childhood Immunisation Programme as far as possible;
• Ensure the availability of comprehensive and appropriate family planning and pregnancy counselling services;
• Assist the Government in developing a policy on Abortion.

Steps:

• Oversee, monitor and evaluate on an ongoing basis the piloting of the cervical screening programme in the Mid-Western Health Board area;
• Following two years' experience of the pilot, commence the introduction of the national cervical screening programme;
• Establish a National Disease Surveillance Unit before the end of 1998;
• Monitor progress in Primary Childhood Immunisation Programme;
• Assist Cabinet Committee to prepare a Green Paper on Abortion by Summer 1998;
• Request health boards to review family planning and counselling services in their areas.

Dental Services

Objectives:

• Reduce the level of dental disease in children;
• Improve the level of oral health in the population overall.

Steps:

• Set oral health targets for key age groups and establish an oral health database for monitoring changes in oral health;
• Increase efficiency and number of water fluoridation schemes;
• Promote increased use of fluoride mouthrinses and fluoride toothpaste especially in low fluoride areas;
• Continue implementation of Dental Health Action Plan;
• Develop specialised dental services through the establishment of regional consultant services.

Drugs/AIDS Services

Objectives:

• Oversee the implementation by health boards of a comprehensive preventive and curative programme covering all aspects of drugs misuse;
• Participate in the work of the National Drugs Strategy Team;
• Ensure the provision of comprehensive HIV/AIDS prevention and treatment services;
• Enhance rehabilitation services for those addicted to drugs.

Steps:

• Continue to expand drug treatment facilities, especially in the Eastern Health Board area;
• Involve more General Practitioners and pharmacists in local provision of drug treatment;
• Improve the database on the nature and extent of drugs misuse;
• Continue support for the prevention initiatives on HIV/AIDS;
• Improve systems for the surveillance of the incidence of HIV/AIDS;
• Continue to focus on the provision of appropriate treatment and care services for people with HIV/AIDS;
• Continue to expand rehabilitation places provided by health boards in co-operation with voluntary and community organisations as well as statutory organisations such as FAS.

General Medical Services

Objectives:

• Promote the effective, efficient and economic development of the General Medical Services and Community Drugs Schemes;
• Ensure a value for money return on the public investment in general practice;
• Ensure the provision of a high quality, cost-effective and accountable community pharmacy service;
• Introduce mechanisms to control the cost and supply of drugs and medicines in general practice and the community.

Steps:

• Evaluate and monitor the level of investment in general practice;
• Ensure that community pharmacy services are properly structured;
• Continue the operation of the Indicative Drugs Target Savings Scheme;
• Extend the principles of the Indicative Drugs Target Savings Scheme to the Community Drugs Scheme;
• further develop initiatives to control the cost and supply of drugs and medicines;
• develop initiatives to ensure consumer awareness of the benefits that flow from measures to control the cost of drugs;
• Liaise with General Practitioners, pharmacists and health boards as necessary. Food, Medicines and Environmental Health

Objectives:

• Undertake measures to protect the health and safety of the public in relation to:
  • food;
  • medicines;
  • tobacco;
  • environmental health issues;
• Ensure that the State complies with EU and international regulatory requirements in relation to the above matters.

Steps:

• Complete transfer of functions to Irish Medicines Board;
• Create database of licensed medicinal products;
• Enact Food Safety Authority of Ireland Bill;
• Oversee establishment and development of Food Safety Authority;
• strengthen food control function in health boards;
• Proceed with early transposition of EU Directives;
• Review procedures for handling food safety alerts in conjunction with health boards;
• Develop Smoke-Free policy;
• Complete National Environmental Health Action Plan by early 1999.

SECONDARY CARE

Objectives:

• Implement the commitment of the health strategy in relation to the relationship between the Department, the health boards and the voluntary hospitals;
• Progress the achievement of regional self-sufficiency in acute hospital services;
• Further develop the capacity of the ambulance services in partnership with other providers of pre-hospital care;
• Progress integrated prevention and care strategies relating to cancer, cardiovascular disease and accidents;
• Link the allocation of base funding and new development funding for hospitals more closely with activity, cost analysis and quality measures;
• Monitor the effectiveness of new and existing technologies in the acute hospital sector.

Steps:

• Participate in the implementation of the proposals to establish the Eastern Regional Health Authority and facilitate the putting in place of appropriate new funding mechanisms for the voluntary hospitals;
• Agree a comprehensive commissioning programme of acute hospital developments to include developments underway, planned, and under active consideration in all health board areas, including the voluntary sector;
• Continue preparations for the establishment of a heart/lung transplant programme in Ireland;
• Assist the Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, in completing the merger of activities at the base hospitals and in transferring its services to the new hospital in Tallaght;
• Assist the Tallaght Hospital Board in the completion of its work;
• Promote the development of an integrated approach to the delivery of emergency medical services;
• Progress the development of a clinical audit system for the ambulance service;
• Continue to co-ordinate the implementation of the Cancer Strategy;
• Develop and implement integrated strategies in relation to cardiovascular disease and accidents;
• Develop the casemix model and implement a methodology having regard to activity, cost and quality;
• Review the Waiting List Initiative to improve its efficiency and effectiveness;
• Institute a system to assess new technology and to monitor the effectiveness of existing technology in the acute hospital sector.

CHILDREN AND DISABILITY

Child Care Policy Unit

Objectives:

• Monitor the implementation by Health Boards of the Child Care Act, 1991;
• Initiate proposals at a national level for the further development of child care services;
• Develop a modern legislative framework to reflect contemporary adoption practice.

Steps:

• Continue the programme of development of child protection and family support / preventive services;
• Establish a Social Services Inspectorate for inspection of and promotion of good practice in child care services;
• Continue implementation of the recommendations of the Kilkenny Incest Investigation Report, Kelly Fitzgerald Report and Madonna House Report;
• Support Minister of State in passage through the Oireachtas of the Adoption (No 2) Bill, 1996, the Children Bill, 1996 and the Protections for Persons Reporting Child Abuse Bill, 1998;
• Review Child Abuse Guidelines and prepare a White Paper on Mandatory Reporting;
• Review foster care services;
• Continue to participate in Partnership 2000 Expert Working Group on Child Care with particular reference to Part VII of the Child Care Act, 1991;
• Prepare legislation to enable the State to ratify the Hague Convention on Protection of Children and Co-Operation in respect of Intercountry Adoption;
• Prepare legislation to provide for post adoption follow-up reports in inter-country adoption;
• Prepare legislation to establish a post adoption contact system.

Disability Services and Services for Travellers

Objectives:

• Assist persons with mental handicap, physical and sensory disabilities to achieve their full potential through the development of appropriate services;
• Establish a new partnership between the Department, the health boards and the voluntary agencies;
• Improve the quality and quantity of training and work opportunities for people with disabilities;
• Achieve an improved health status in the Travelling Community by measures designed to increase their level of take-up of services.

Steps:

• Pursue the development of services for persons with a mental handicap as outlined in Assessment of Need for Services for Persons with a Mental Handicap 1997-2001;
• Implement the £30m capital programme for the mental handicap services over the next four years;
• Complete the process of the transfer of responsibility for the funding of the voluntary mental handicap agencies in the remaining six health boards, to take effect in five of the boards from 1st January 1999 and in the Eastern Health Board area from 1st January 2000;
• Pursue the development of services for persons with a disability in line with the recommendations of Towards an Independent Future;
• Develop more effective processes to measure the quality, effectiveness and outcomes, including the development of standards where appropriate, of services for people with disabilities;
• Develop skills training for support staff in disability services;
• Increase the number of sheltered employment and training places for persons with disabilities to meet the targets set out in Partnership 2000;
• Appoint a Traveller Health Advisory Committee to include Traveller interests;
• Publish a policy statement on Travellers' Health;
• Continue to support health boards in their initiatives to improve services for the homeless;
• Continue development of specialist services for people with autism, where required;
• Continue the development of respite care.

BLOOD POLICY, MENTAL HEALTH AND SERVICES FOR OLDER PEOPLE

Blood Policy Division

Objectives:

• Ensure the BTSB is supported in achieving and maintaining the highest internationally-accepted standards of safety in relation to blood and blood products;
• Ensure that appropriate health care services are available to meet the current and future needs of persons infected by blood and blood products.

Steps:

• Ensure the full implementation of the recommendations of the Tribunal of Inquiry into the Blood Transfusion Service Board (BTSB);
• Support and oversee the restructuring of the BTSB as set out in the Report of the Tribunal of Inquiry, the Board's Development Plan and the Bain Report;
• Support the BTSB in monitoring and, where appropriate, implementing emerging new technologies which will improve the safety and efficacy of blood components in accordance with best international practice;
• Ensure the relocation of the BTSB to new, purpose-built premises which will meet pharmaceutical industry standards;
• Review the provision of primary and secondary health care services for persons with Hepatitis C;
• Support the Consultative Council on Hepatitis C and the special Hepatitis C research programme;
• Establish a Tribunal of Inquiry into the HIV and Hepatitis C infection of persons with haemophilia.

Mental Health Services and Services for Older People

Objectives:

• Continue the modernisation of mental health services;
• Promote the further development of services for older people.

Steps:

• Prepare new mental health legislation;
• Monitor progress in relation to implementation of suicide reduction / prevention strategies;
• Promote quality assurance in the delivery of mental health services;
• Develop a national policy on child and adolescent psychiatric services;
• Continue the programme of development of community-based psychiatric services;
• Develop plan for the organisation of services for the disturbed mentally ill;
• Promote the further development of services for older people, including the development of specialist mental health services;
• Continue the development of palliative care / hospice care services in line with the National Cancer Strategy;
• Review the nursing home subvention.

MEDICAL DIVISION

Objectives:

• Provide specialist medical advice and support to the Minister and Department on key priority issues as they arise;
• Lead the development and implementation of medical manpower and training policy;
• Publish an Annual Report on the state of health in the country.

Steps:

• Finalise proposals for the identification and mobilisation of adequate and appropriate external medical advice;
• Continue the consultative process relating to medical manpower/training to complete the major training initiative recently undertaken with the Irish Committee for Higher Medical Training;
• Formulate proposals on medical manpower/training to build on progress made to date;
• Agree firm plans to resolve existing medical manpower problems and commence implementation;
• Contribute to the establishment of the National Communicable Diseases Surveillance Unit and the preparation of up-dated vaccination guidelines;
• Contribute to the analysis of health agenciesÕ service plans with particular emphasis on evidence-based service provision, medical audit and outcome measurement;
• Assist in the continued consideration of medico-legal and ethical issues;
• Continue consideration of the appropriate strategy and structure for the assessment and diffusion of medical technology in the health service.

PERSONNEL MANAGEMENT AND DEVELOPMENT

Objectives:

• Support the further development of the Health Service EmployersÕ Agency;
• Ensure optimum devolution to health agencies of day-to-day responsibility for personnel issues;
• Ensure the application of public sector pay policy in the health services;
• Develop a strategy for the introduction of new arrangements for medical indemnity;
• Further progress the Management Development Strategy;
• Support the work of the Nursing Commission and lead the ensuing implementation programme.

Steps:

• Transfer to the Health Service EmployersÕ Agency the provision of advice to the health agencies on the interpretation and implementation of employment conditions, including employment law;
• Transfer to the Health Service EmployersÕ Agency the responsibility for the administration of the voluntary hospitals' and nominated health agencies' superannuation schemes;
• Ensure progress towards the implementation in the health services of the key goals of partnership in accordance with Partnership 2000;
• Assist health service employers in the development of modern human resource management policies for the health service;
• Initiate a detailed examination of the need for the introduction of accreditation systems for health professionals;
• Devolve responsibility in respect of disciplinary matters to CEOs of agencies;
• Implement the 1997 Consultants' Contract, including provisions to involve consultants in the management process at hospital level;
• Gain support of health service agencies and medical profession for proposed strategy on medical indemnity and prepare proposals for Government;
• Continue work with Office for Health Management to identify areas of Management Development Strategy for action;
• Identify development needs of consultants in new management arrangements;
• Develop manpower planning criteria appropriate for nursing;
• Ensure the ongoing development of nursing education and training.

FINANCE, PLANNING AND INTERNATIONAL

Planning and Evaluation Unit

Objectives:

• Further develop service planning and its implementation;
• Promote an evaluative approach to service development and review to support the effective working of the Department in its policy focused role;
• Support the work of the Department in policy analysis, development and review;
• Review and streamline the regulatory framework for eligibility for health services;
• Support the attainment of value for money by the health agencies in the materials management area;
• Initiate a series of comprehensive value for money audits in the health service;
• Monitor the implementation of the Department's commitments in relation to social inclusion set out in Partnership 2000;
• Review the Health Strategy and co-ordinate preparation of a new Strategy for 1999 - 2010.

Steps:

• Lead and facilitate Departmental and health agency representatives in specifying the requirements to be included with service plans so as to better enable the Department to analyse, agree and monitor these plans;
• Facilitate the development and use of performance indicators in the monitoring of service plans and the assessment of policy requirements;
• Promote the appropriate linkages between Departmental objectives and health agency service plans;
• Enhance and extend our analytical capabilities through the most effective means available;
• Support the implementation of the report of the Materials Management Advisory Group;
• Develop and establish a framework, based on best practice and methodologies most suitable for the Irish health care context, to be used by the Department (and, if possible, the health agencies) in carrying out evaluations and service reviews;
• Ensure that evaluation and service review are appropriately catered for in health agency service plans;
• Ensure that a series of value for money audits are carried out in the context of the implementation of the Materials Management Advisory Committee and the programme of expenditure reviews agreed with the Department of Finance;
• Review eligibility framework with a particular focus on long stay charges, medical card eligibility of the elderly and large families and uniform interpretation of provisions relating to retention of medical cards by long term unemployed persons entering employment or approved work schemes;
• Monitor and review the bed designation system established pursuant to the Health (Amendment) Act, 1991;
• Co-ordinate the monitoring of progress on implementation of Partnership 2000.

Information Management Unit

Objectives:

• Provide a statistical and analytical resource for the Department;
• Manage and develop the Department's principal data collection systems including the production and dissemination of reports.

Steps:

• Continue to develop the Public Health Information System as a key source of national and regional data on population-based health indicators for the purposes of policy and planning;
• Play a full role in the EU Programme on Health Monitoring and work closely with the WHO and OECD in the continuing development of comparative international health information systems;
• Rationalise the HIPE and Perinatal data collection systems through the transfer of certain functions to appropriate agencies;
• Improve the use and timeliness of the Integrated Management Returns and integrate them into the development and evaluation of service plans;
• Update and improve the Report on Health Statistics;
• Further develop the statistical budget model which underpins the casemix programme;
• Participate in data collection initiatives in the area of accidents and ensure that the European Home and Leisure Accident Surveillance System is incorporated into these developments.

Finance and Accounting

Objectives:

• Review methodology for developing the health estimates and the associated multi-annual budgeting process;
• Further develop service planning and implementation;
• Further the development of the finance function in the health boards;
• Ensure that the highest accounting standards are met by the Department, the health boards and the agencies;
• Give advice on professional accounting matters generally.

Steps:

• Refine the Unit's and the Division's methodology and timing for determining future funding requirements;
• Develop linkages between the estimating process and the service evaluation exercise;
• Review and monitor service plans in accordance with legislation;
• Assist in the continuing development of the structure and content of service plans;
• Assist in the implementation of service planning in the new Eastern Regional Health Authority;
• Update financial and accounting systems throughout the health boards;
• Develop the concept of devolved management of the finance function.

Health Insurance and International

Objectives:

• Ensure that community rating remains the core principle underlying private health insurance in the State;
• Enable the development of a competitive private health insurance market;
• Discharge the Department's international obligations, particularly within the European Union and the World Health Organisation.

Steps:

• Prepare a White Paper on private health insurance covering its role in the overall health care system, the regulation of the private health insurance market and the corporate structure and status of the Voluntary Health Insurance Board;
• Represent the national interest in relation to health matters in the EU, WHO and other international fora;
• Promote further North/South co-operation in health matters.

Hospital Planning Office

Objectives:

• Ensure that the best use is made of the State's investment in the capital programme;
• Devolve executive work in relation to capital development to other agencies to the maximum extent possible;
• Develop the evaluation function of the Hospital Planning Office.

Steps:

• Manage the capital programme;
• Review existing methods of facilities procurement and investigate new methods to meet differing needs;
• Implement a policy for the collection, transportation, treatment and disposal of healthcare risk waste;
• conduct an assessment of hospital equipment needs - new and replacement - and implement a planned programme to meet these needs;
• progress, in consultation with agencies, the devolution of executive work;
• develop the evaluation of the operational, quality and economic performance aspects of capital projects.

STRATEGIC POLICY DEVELOPMENT

Corporate Services Division

Objectives:

• Provide efficient, effective and high-quality support services to the Department in the areas of: information technology, library and information services, office administration, management of the administrative budget and human resources;
• Develop staff training and development programmes to enable all staff to reach their full potential;
• Implement the civil service reform process within the Department;
• Enhance the provision of information to the general public;
• Progress the establishment of the Eastern Regional Health Authority in co-operation with the Task Force;
• Ensure that the Department can meet the requirements of the Freedom of Information Act, 1997 and support the health agencies in meeting those requirements.

Steps:

• Update the computer network in the Department and restructure the internal systems unit;
• Provide a customised Management Development Programme to all Assistant Principals and Principals over the next two years;
• Provide personal development courses for clerical and executive grades in 1998;
• Assess I.T. training needs of all new staff and address same;
• Implement the Department's Customer Service Action Plan;
• Co-ordinate the Working Group on the provision of health services public information and present recommendations for improvements;
• Expand the Department's internal and external electronic publishing programme (web site and internal intranet);
• Widen and deepen the SMI process within the Department and support its extension to health boards and agencies;
• Progress legislation for the establishment of the Eastern Regional Health Authority;
• Liaise closely with the Task Force on the Eastern Regional Health Authority and participate in the work of the internal Project Team to formulate the policy context for the implementation of the new structures;
• Publish a guide to the Department as required by the Freedom of Information Act;
• Agree a records management strategy, implementation plan and procedure manual for the Department;
• Facilitate the expansion of the remit of the Ombudsman to include medical areas.

Systems Unit

Objective:

• Ensure that the health services incorporate the appropriate developments in Information Technology and Telematics in providing high-quality patient administration, clinical services and resource management.

Steps:

• Manage the information systems capital programme so that the highest value is obtained from it;
• Progress, in consultation with the agencies, the devolution of IT developments;
• Progressively build up a strong strategic review and evaluation capacity within the unit, with an emphasis on standards and best practice;
• Provide IT development advice and assistance to the health agencies generally and to the General Register Office;
• Maintain and develop the highest levels of IT strategic competencies in the unit through staff development and training.

Health Promotion Unit

Objectives:

• Pursue the achievement of the health promotion targets outlined in the Health Strategy and the Health Promotion Strategy;
• Continue to develop the multi-sectoral approach to health promotion;
• Strengthen the health promotion function at local level.

Steps:

• Encourage the development of locally based health promotion initiatives in schools, workplaces, the community, hospitals and healthcare facilities;
• Pursue the devolution of certain executive functions to the health boards;
• Initiate a national multi-media alcohol awareness campaign;
• Reconstitute the National Consultative Committee on Health Promotion;
• Initiate a new multi-media anti-smoking campaign;
• Strengthen school-based anti-smoking initiatives already in place.

Women's Health Policy

Objectives:

• Put the Women's Health Council on a firm administrative footing;
• Develop a process for the implementation by the health boards of relevant aspects of the Women's Health Plan;
• Develop priorities within the Department for the implementation of relevant aspects of the Women's Health Plan;
• Secure, in consultation with the health boards, adequate resourcing for women's health, including rape crisis centres and refuge accomodation for women fleeing domestic violence.

Steps:

• Liaise with other sections of Department in relation to provision of accommodation and agreement of budgetary procedures for Women's Health Council;
• Support Chair and Council until appointment of Director;
• Develop draft implementation process for health boards and agree with liaison officers;
• Monitor implementation with health board liaison officers on a regular basis;
• List actions for Department and agree priorities, in conjunction with other sections;
• Establish and chair a steering group to monitor implementation.

GENERAL REGISTER OFFICE

Objectives:

• Ensure juridical adequacy in the civil registration function, i.e. the acceptability as evidence of the register entries and the certified copies made therefrom;
• Engage in a process of consultation with client groups to establish consumer satisfaction;
• Review the day to day running of the Office with a view to identifying operational matters requiring attention.

Steps:

• Liaise closely with the Department of Social, Community and Family Affairs in the review of the civil registration legislation;
• Develop public awareness of the rationale for the current registration system;
• Secure the involvement of the primary qualified informant in the registration process;
• Review the Civil Registration System with a view to simplifying the registration requirements;
• Improve accommodation, opening hours, forms design, information to the public and staff training;
• Establish formal grievance procedures for customer groups;
• Consult with users of the service;
• Invest in new technology with the aim of improving the service to the public.