IMPACT has made progress with the HSE in discussions about proposed structures for community healthcare organisations (CHOs), the new structures for managing community and primary health care services. But the union, which is now preparing to enter formal discussions, has warned that ad hoc arrangements are developing because of the lack of detailed proposals from the HSE.

IMPACT national secretary Eamonn Donnelly said the HSE’s latest health plan provides for a number of functioning operational networks in each CHO area. “The HSE has made a proposal to have one pilot network in each CHO area. Up to this point we have only reached an interim agreement on the very senior management and admin structures from chief officer to general manager,” he said.

In a recent letter to HSE management, Eamonn said the absence of any structured proposal from the HSE had placed “an unbearable burden on the system allowing the gestation of an ad hoc approach from area to area.”

He said that IMPACT will proceed with negotiations on the establishment of a learning site in each CHO area on two conditions:

• The learning site structures must be interim and must not prejudice the outcome of discussions on permanent structures
• Discussion and negotiation must be overseen by a HSE/IMPACT consultative group, which can assign tasks to smaller consultative groups populated by relevant grades, groups or categories.

On the creation of the consultative groups, Eamonn said this provided an opportunity to involve grades, groups and categories that are directly affected by the subject of particular discussion.

“It provides a real opportunity to mobilise ourselves properly. For example, if the health minister decided that nine CHOs and seven hospital groupings wasn’t fit for purpose, and switched to a proposal for six integrated healthcare areas, we would be organised fluidly enough to adapt to that structure,” he said.

Eamonn said a smaller scale approach to the same structures is also taking place in the disability sector as part of the HSE’s Progressing Disabilities plan.