THE FUTURE of key elements of the health sector reform programme is in doubt, following the decision of the board of the Health Service Executive not to fill three top-level posts in the organisation earlier this week.
HSE chief executive Prof Brendan Drumm told his senior management earlier this week in an internal memo that the three posts concerned – the national director of operations, the national director of planning and performance and the national director of quality and clinical care – had been seen as “essential drivers” of the organisation’s new integrated services programme.
This plan would have involved the establishment of new regional structures around the country to administer services and the abolition of the parallel systems for running hospital and community services.
The proposed new regional centres were to have reported directly to the new national director of operations while new clinical directors in hospitals – a key element of the reform of the hospital consultant contract – were to have had a close working relationship with the national director of quality and clinical care.
However, last Monday the board of the HSE decided that the three newlycreated director posts should not be filled.
The HSE told The Irish Timesthis decision was a result of the current financial pressures on the organisation, the lack of clarity surrounding a voluntary redundancy-early retirement scheme and the Government's moratorium on recruitment and promotion.
“This decision has nothing to do with the persons recommended by the interview panels,” the HSE said.
However, the recommendations in relation to the three top-level posts had gone to the HSE board earlier this month before the recruitment embargo was introduced and at a time when the organisation was aware it was facing a potential €1 billion deficit.
The Irish Timesreported last month that there was significant disagreement between Prof Drumm and the board over who had the final say in making the appointment in relation to one of the key posts.
Asked whether it was intended to re-advertise the three national director positions, the HSE said: “The board is going to re-examine these three posts in the light of the financial challenges facing the HSE currently. Any decision in this regard will have to be cognisant of the Government recruitment embargo and its meaning for these three posts.”
The HSE said its board remained fully committed to the regionalisation and integration policy and had indicated it wished “to accelerate both of these important initiatives without delay”.
“In this regard the chief executive and management team will identify options that will allow both policies to progress. These policies have been under way for the past two years and when fully implemented will greatly enhance patient access and the quality of healthcare delivery.”
The HSE said it had spent nearly €19,000 in fees paid to an executive recruitment company to identify potential candidates for the posts, which have now not been filled. It said further costs incurred by the Public Appointment Service in relation to the competitions for the posts had not yet been determined.
Prof Drumm said this week he would “be working closely with a core team to identify options that may enable us to continue and accelerate the integration initiatives we have been working on during the past two years”.