Health board (Ireland)


The health board system of Ireland was created by the 1970 Health Act. This system was initially created with eight health boards, each of which were prescribed a functional area in which they operated. The system was reformed in 1999 from eight to eleven regional bodies.
On 1 January 2005, the health boards were replaced by the Health Service Executive.

Background

Prior to the advent of the health board system, the 1947 Health Act was the principal legislation on the State's role in the provision of healthcare in Ireland; this was the act that served as the legislative basis for the Mother and Child Scheme, which was later withdrawn under Church and doctor opposition.
Under the 1947 act, the health authority for a functional area was the city council or county council of that area. This reflected the fact that until 1947, the Minister for Local Government and Public Health was responsible for public health, and in that year, the Minister for Health was created as a separate Minister of the Government by the 1946 Ministers and Secretaries Act.
In 1970, the healthcare system of Ireland was still very much a private and voluntary system with the Catholic Church still retaining effective control of healthcare, in particular, the ownership of hospitals and institutions. Doctors served very much in a sole trader capacity with the state taking few responsibilities beyond the organisation of the provision of healthcare to the disadvantaged.

Health boards

In 1970, the Health Boards Regulations were made under the Health Act, 1970 and defined among other things the functional area, membership and composition of each health board. Each health board was headed by a chief executive officer and more often assisted by an "ad hoc" management team consisting of professionals who were public servants.
Health boardCodeMembersFunctional area
Eastern Health BoardEHB35Dublin City, County Dublin, County Kildare, County Wicklow
Midland Health BoardMHB30County Laois, County Offaly, County Longford, County Westmeath
Mid-Western Health BoardMWHB28County Clare, Limerick City, County Limerick, Tipperary North Riding
North-Eastern Health BoardNEHB30County Louth, County Meath, County Cavan, County Monaghan
North-Western Health BoardNWHB27County Donegal, County Sligo, County Leitrim
South-Eastern Health BoardSEHB31County Carlow, County Kilkenny, County Wexford, Waterford City, County Waterford, Tipperary South Riding
Southern Health BoardSHB33Cork City, County Cork, County Kerry
Western Health Board†WHB29County Galway, County Mayo, County Roscommon

1999 Reforms

In the late 1990s, the counties of Dublin, Kildare and Wicklow represented almost half of the population of the state and had only one health board, the Eastern Health Board. The rest of the state was served by seven health boards, each with a designated functional area. The 1999 Health Act was introduced and dissolved the Eastern Health Board and created four bodies in its place, thus bringing to eleven the number of regional health authorities and boards.
The Eastern Regional Health Authority was given overall responsibility for the former health board functional area, however the actual provision of services was delegated to three area health boards. These area health boards were; the Northern Area Health Board, East Coast Area Health Board and the South-Western Area Health Board.
The functional areas of the area health boards did not correspond exactly to the city and county council boundaries and instead were defined in the First Schedule of the Act. The 1999 Eastern Regional Health Authority Regulations determined the composition of the board of each area health board. The composition of the Eastern Regional Health Authority was determined by the act.