Chapter 7: The Irish Health Service’s Expert Advisory Groups: Spaces for Advancing Epistemological Justice?
Orla O’Donovan In February 2006 the Irish Health Services Executive (HSE) placed notices in national newspapers seeking expressions of interest for membership of its proposed Expert Advisory Groups (EAGs). Replacing 11 regional health boards with a single centralized apparatus, the HSE had been established a year earlier and was heralded in official discourses as signifying the beginning of not just major reform of the Irish health care system but its transformation. Acknowledging the dysfunctional and expensive character of the existing system, in his opening comments in the HSE’s Transformation Programme 2007–2010 (2007: 5), HSE CEO Brendan Drumm stated that he deliberately used the term ‘transformation’ to describe the radical changes underway because ‘reform’ had come to refer to the modest project of organizational and administrative change: ‘Our transformation must extend much further and touch almost every aspect of our work; the way we work, the way we relate to each other, our culture and our ambitions.’ In contrast to this official celebration of the HSE, critics, including some senior bureaucrats, argued that the health service would not be better governed by further centralizing responsibility for service delivery or by reducing the role of elected representatives who served on the regional health boards (Donnellan 2003). For others the new division of labour – the Department of Health and Children would be responsible for health care legislation, policy and financial accountability, and the HSE in charge of management and delivery of health care – constituted an outsourcing of government, reducing the government department...
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