Health Service Executive (Governance) Act 2019

PART 1 Preliminary and General

1. Short title, commencement, collective citation and construction

1. (1) This Act may be cited as the Health Service Executive (Governance) Act 2019.

(2) This Act shall come into operation on such day or days as the Minister for Health may by order or orders appoint either generally or with reference to any particular purpose or provision and different days may be so appointed for different purposes or different provisions.

(3) This Act, other than Part 3, shall be included in the collective citation “Health Acts 1947 to 2019” and shall be read together as one with those Acts.

2. Definition

2. In this Act, “Principal Act” means the Health Act 2004.

3. Repeals

3. Each of the following is repealed:

(a) Part 3A of the Principal Act;

(b) section 22 of the Health Service Executive (Governance) Act 2013.

PART 2 Amendment of Principal Act

4. Amendment of section 2 of Principal Act

4. Section 2 of the Principal Act is amended, in subsection (1)—

(a) by the insertion of the following definition:

“ ‘Committee of Public Accounts’ means the Committee of Dáil Éireann established under the rules and standing orders of Dáil Éireann to examine and report to Dáil Éireann on the appropriation accounts and reports of the Comptroller and Auditor General;”,

(b) by the substitution of the following definition for the definition of “Board”:

“ ‘Board’ has the meaning assigned to it by section 16N;”,

(c) by the substitution of the following definition for the definition of “chief executive officer”:

“ ‘chief executive officer’ has the meaning assigned to it by section 21A;”,

(d) by the substitution of the following definition for the definition of “member”:

“ ‘member’, in relation to the Board, includes the chairperson and the deputy chairperson;”,

(e) by the substitution of the following definition for the definition of “ordinary member”:

“ ‘ordinary member’ means a member of the Board other than the chairperson or the deputy chairperson;”,

and

(f) by the deletion of the definitions of “appointed director” and “appointed member”.

5. Amendment of section 7 of Principal Act

5. Section 7 of the Principal Act is amended, in subsection (5), by the substitution of the following paragraph for paragraph (c):

“(c) the policies (whether set out in codes, guidelines or other documents, or any combination thereof) and objectives of the Government or any Minister of the Government to the extent that those policies and objectives may affect or relate to the functions of the Executive,”.

6. Amendment of section 10 of Principal Act

6. Section 10 of the Principal Act is amended—

(a) in subsection (1)—

(i) by the substitution of “to the Executive or the Board” for “to the Executive”, and

(ii) in paragraph (c), by the substitution of “that the Executive or the Board, as applicable, is not having sufficient regard to such policy or objective in the performance of the Executive’s functions” for “that the Executive is not having sufficient regard to such policy or objective in the performance of its functions”,

(b) in subsection (2)—

(i) in paragraph (a), by the substitution of “subsection (1),” for “subsection (1), and”,

(ii) in paragraph (b), by the substitution of “functions, or” for “functions.”, and

(iii) by the insertion of the following paragraph after paragraph (b):

“(c) subject to section 10AA(1) and (3), one or more than one health needs assessment (within the meaning of section 10AA(8)) to be implemented by the Executive in the service plan prepared in accordance with section 31.”,

(c) in subsection (5), by the substitution of “The Executive or the Board, as applicable,” for “The Executive”,

(d) in subsection (6), by the substitution of “or issuing a direction under subsection (4) amending or revoking a direction issued under subsection (1)” for “or (4)”, and

(e) in subsection (7), by the substitution of “The chairperson shall inform the Minister of the measures taken by the Executive or the Board, as applicable,” for “The Director General shall inform the Minister of the measures taken by the Executive”.

7. Health needs assessment

7. The Principal Act is amended by the insertion of the following section before section 10B:

“10AA. (1) A direction under section 10(2)(c) shall include specific requirements to be taken into consideration by the Executive when conducting a health needs assessment.

(2) Without prejudice to the generality of subsection (1), the specific requirements referred to in that subsection may include the effects of such of the following matters on the accessibility and effectiveness of healthcare strategies implemented by the Executive as the Minister is satisfied are appropriate:

(a) changes to national or regional distribution of population;

(b) demographic profile of population;

(c) lifestyle factors affecting health;

(d) patterns of morbidity across population;

(e) patterns of mortality across population;

(f) social determinants of health status.

(3) (a) The Minister shall consult with the Minister for Public Expenditure and Reform before issuing a direction under section 10(2)(c).

(b) Paragraph (a) shall not be construed to prevent the Minister from consulting with any other person (including the Executive or another Minister of the Government) before issuing a direction under section 10(2)(c).

(4) The Executive shall submit a report of the findings of any health needs assessment to the Minister within the period specified by the Minister in the direction concerned under section 10(2)(c).

(5) (a) Within one month after receiving a report under subsection (4), the Minister shall—

(i) approve the report, or

(ii) if the Minister is not satisfied with the report, issue a supplementary direction under section 10(2)(c) in relation to revisions to be made to the report which, when complied with by the Executive, should, in the opinion of the Minister, remedy the deficiencies in the report.

(b) Where paragraph (a)(ii) applies, section 10(2)(c) and the other provisions of this section (including paragraph (a)) shall be construed with all necessary modifications to take account of the supplementary direction concerned under section 10(2)(c).

(6) The Executive shall ensure that, as soon as practicable after the approval of a report in accordance with subsection (5)(a)(i), the report is published on the Internet or in accordance with such other arrangements as the Minister may specify by notice in writing given to the Executive.

(7) The Minister may issue guidelines in relation to the conduct of a health needs assessment and, if he or she does so, the Executive shall comply with those guidelines.

(8) For the purposes of this section and section 10, ‘health needs assessment’ means a scientific, statistical or other systematic analysis, the purpose of which is to gather and assess information with a view to bringing about change beneficial to the health of a specified part of, or all of, the population.”.

8. Amendment of section 10B of Principal Act

8. Section 10B of the Principal Act is amended, in paragraph (d), by the substitution of “chief executive officer” for “Director General”.

9. Board of Executive

9. The Principal Act is amended by the insertion of the following Part after Part 3A:

“Part 3B

Membership of Board

16N. (1) The Executive shall have a Board (in this Act referred to as the ‘Board’) consisting of the following members:

(a) a chairperson;

(b) a deputy chairperson;

(c) 10 ordinary members.

(2) (a) Subject to paragraphs (b), (c) and (d), the chairperson, the deputy chairperson and the ordinary members of the Board shall be appointed by the Minister from among persons who, in the opinion of the Minister, have sufficient experience and expertise relating to matters connected with the functions of the Executive to enable them to make a substantial contribution to the effective and efficient performance of those functions.

(b) At least 2 of the persons appointed under paragraph (a) shall be persons who, in the opinion of the Minister, have experience of, or expertise in, advocacy in relation to matters affecting patients.

(c) At least 2 of the persons appointed under paragraph (a) shall be persons who are practising, or have practised, as a member of a health profession, whether in or outside the State.

(d) At least one of the persons appointed under paragraph (a) shall be a person who, in the opinion of the Minister, has experience of, or expertise in, financial matters.

(3) The Minister shall, in so far as practicable, endeavour to ensure that among the members of the Board there is an equitable balance between men and women.

(4) The chairperson shall hold office for such period, not exceeding 5 years from the date of appointment, as the Minister shall determine.

(5) The deputy chairperson shall hold office for such period, not exceeding 5 years from the date of appointment, as the Minister shall determine.

(6) Subject to subsection (7), an ordinary member shall hold office for such period, not exceeding 5 years from the date of appointment, as the Minister shall determine.

(7) Of the ordinary members of the Board first constituted under this section—

(a) 5 members shall hold office for a period of 3 years from the date of appointment to the office, and

(b) 5 members members shall hold office for a period of 5 years from the date of such appointment.

(8) Subject to subsection (9), a member of the Board whose term of office expires by the efflux of time shall be eligible for reappointment to the Board.

(9) A person who is reappointed to the Board in accordance with subsection (8) shall not hold office for more than 2 consecutive terms and in any event may not serve for a period of more than 10 years.

(10) A member may resign from office by letter sent to the Minister and the resignation shall take effect on the later of—

(a) the date specified in the letter, or

(b) the date of receipt of the letter by the Minister.

(11) The Minister shall, as soon as practicable after an appointment to the Board, publish in Iris Oifigiúil notice of the name of the person so appointed.

(12) For the purpose of this section, ‘health profession’ means any of the following professions:

(a) dentist;

(b) a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005;

(c) medical practitioner;

(d) midwife;

(e) nurse;

(f) pharmacist.

Casual vacancies

16O. (1) If a member resigns, dies, ceases to hold office (other than by effluxion of time), ceases to be qualified to hold office or is removed from office, the Minister shall as soon as practicable appoint a person to fill the casual vacancy so arising.

(2) A person appointed under subsection (1) shall hold office for the unexpired period of his or her predecessor’s term of office or such other period as the Minister may determine not exceeding 5 years including such unexpired period.

(3) A member appointed under subsection (1) is eligible for reappointment to the Board, on the expiry of the unexpired period or other period, as appropriate, referred to in subsection (2), but may not serve for more than 2 further consecutive terms and in any event may not serve for a period of more than 10 years.

Functions of Board

16P. (1) The Board is the governing body of the Executive with authority, in the name of the Executive, to perform the functions of the Executive.

(2) The Board shall—

(a) satisfy itself that appropriate systems, procedures and practices are in place—

(i) to achieve the Executive’s object,

(ii) for the internal performance management and accountability of the Executive in respect of the Executive’s—

(I) performance of its functions,

(II) achieving objectives in accordance with the corporate plan, and

(III) delivery of health and personal social services in accordance with this Act,

and

(iii) in order to enable compliance with the policies (whether set out in codes, guidelines or other documents, or any combination thereof) of the Government or a Minister of the Government to the extent that those policies may affect or relate to the functions of the Executive,

and

(b) establish and implement arrangements for the management of the performance of the chief executive officer.

(3) The Board is accountable to the Minister for the performance of its functions under subsections (1) and (2).

(4) The Board may delegate in writing to the chief executive officer any of the Executive’s functions.

(5) If a function of the Executive is delegated to the chief executive officer under subsection (4), the delegation remains in force until the Board revokes the delegation by notice in writing given to that officer.

(6) The Board shall notify the Minister in writing of any delegation made under subsection (4) and of any revocation of such delegation.

(7) The Board shall inform the Minister in writing of any matter that it considers requires the Minister’s attention.

Membership of either House of Oireachtas or European Parliament

16Q. (1) A person is not eligible for appointment as a member of the Board or a committee of the Board if the person is—

(a) nominated as a member of Seanad Éireann,

(b) elected as a member of either House of the Oireachtas or to be a member of the European Parliament,

(c) regarded pursuant to Part XIII of the Second Schedule to the European Parliament Elections Act 1997 as having been elected to that Parliament, or

(d) elected or co-opted as a member of a local authority.

(2) A person who is for the time being entitled under the Standing Orders of either House of the Oireachtas to sit therein or who is a member of the European Parliament or a local authority shall, while he or she is so entitled or is such a member, be disqualified for membership of the Board or a committee of the Board.

Removal of member of Board

16R. (1) The Minister may at any time remove from office a member of the Board if, in the Minister’s opinion—

(a) the member has become incapable through ill-health of performing his or her functions,

(b) the member has committed stated misbehaviour,

(c) the member’s removal is necessary for the effective and efficient performance by the Board of its functions,

(d) the member has contravened section 25(1) or 26 or an applicable provision of the Ethics in Public Office Act 1995, or

(e) in performing functions under this Act, the member has not been guided by a code of conduct that has been drawn up under section 10(3) of the Standards in Public Office Act 2001 and that relates to the member.

(2) A member of the Board shall cease to be qualified for office and shall cease to hold office if he or she—

(a) is adjudicated bankrupt,

(b) makes a composition or arrangement with creditors,

(c) is sentenced by a court of competent jurisdiction to a term of imprisonment,

(d) is convicted of any indictable offence,

(e) is convicted of an offence involving fraud or dishonesty, whether in connection with a company or not,

(f) is, or is deemed to be, the subject of an order under section 160 of the Companies Act 1990 or a disqualification order within the meaning of Chapter 4 of Part 14 of the Companies Act 2014, or

(g) is removed by a competent authority for any reason (other than failure to pay a fee) from any register established for the purpose of registering members of a profession in the State or another jurisdiction.

(3) A member who does not, for a consecutive period of 6 months, attend a meeting of the Board ceases at the end of that period to hold office unless the member demonstrates to the Minister’s satisfaction that the failure was due to ill-health.

(4) In this section, ‘applicable provision of the Ethics in Public Office Act 1995’, in relation to a member, means a provision of that Act that, by virtue of a regulation under section 3 of that Act, applies to that member.

Removal of all members of Board from office

16S. (1) The Minister may remove all the members of the Board from office if—

(a) the Board fails to achieve a quorum for 3 consecutive meetings,

(b) the Board does not comply with a judgment, order or decree of any court,

(c) the Board does not comply with a direction of the Minister or any other requirement imposed on it by or under any enactment including this Act, or

(d) the Minister is of the opinion that the Board’s functions (in particular, its functions under section 16P) are not being performed in an effective and efficient manner.

(2) The Minister may, if he or she is of the opinion that the Board’s functions are not being performed in an effective and efficient manner, appoint a person to—

(a) conduct an independent review of any matter giving rise to that opinion, and

(b) submit a report to the Minister on the results of the review.

(3) The Board shall co-operate with a review under subsection (2) and give the person conducting it all reasonable assistance, including access to such premises, equipment and records as the person may require for the purposes of the review.

(4) The removal of the members of the Board from office does not revoke or otherwise affect any delegation of the Executive’s functions to the chief executive officer under section 16P(4).

Committees of Board

16T. (1) The Board may establish committees, consisting in whole or in part of persons who are members of the Board, to assist and advise it in relation to the performance of any of its functions.

(2) In appointing members of a committee the Board shall have regard to the knowledge and experience necessary for the proper and effective and efficient discharge of the functions of the committee.

(3) The Board may at any time remove a member of a committee for stated reasons.

(4) The acts of a committee shall be subject to confirmation by the Board, unless the Board otherwise determines.

(5) The Board may determine the terms of reference and the procedures of a committee.

(6) The Board may appoint a member of a committee to be the chairperson of a committee.

(7) A committee shall provide the Board with such information as the Board may from time to time require, in respect of the committee’s activities and operations, for the purposes of the performance by the Board of its functions.

(8) The Board may at any time dissolve a committee.

(9) In this section, ‘committee’ means a committee established under subsection (1).

Remuneration and expenses of members of Board and committees