Free access to an adequately-funded public health system, which mainstreams currently marginalised services like mental health, are among the measures unions say should guide health service reforms.

A recent meeting of health service unions outlined the six principals as health minister Simon Harris announced long-expected plans to establish six new health areas, in a move to devolve authority from the national HSE to local regions.

Once established, the six regional bodies are meant to plan, fund, manage and deliver integrated care in each region.

Harris said the new regions were in line with SláinteCare proposals for improved health services, which achieved cross-party support in 2017. They had been established on the basis of population statistics, data on how people currently access health services, and a public consultation, he said.

A “co-design process,” in which stakeholders – including staff and their unions – will be invited to contribute to the design of services in each new regional health area, will now take place. And details of the national and regional organisational design will be brought back to Government for approval within 12 months.

Speaking at the announcement, new HSE chief executive Paul Reid said the new regions would support and enable staff to deliver the best care possible. “Since I joined the HSE, I have met staff right across the country who work tirelessly to deliver the best care possible, and who have great energy and ambition for constantly improving what we do, and how we do it. However, our current structures do not always support them in doing this,” he said.

Meanwhile, the Irish Congress of Trade Unions (ICTU) Health Sector Group, which includes Fórsa, Siptu and the Irish Nurses and Midwives Organisation, agreed the following principles, which it said should guide health reforms:

• Accessible public health services, free at the point of use
• A public health service that provides timely and efficient healthcare to those in need
• A properly-resourced health service that ensures the best standards of patient care
• Hospital, primary and community healthcare that is geographically accessible
• A revised model of general practitioner care, and
• The ‘de-marginalisation’ of critical health services like mental health.