HSE and Department of Health exodus not just down to Covid

The current exodus from the Department of Health and the HSE has its roots in Covid, but insiders say it is also driven by an array of institutional factors.

As Paul Cullen wrote in these pages on Wednesday, a trickle has become a flood, with Dr Tony Holohan and his deputy Dr Ronan Glynn the most high-profile examples.

Anne O’Connor, the HSE’s chief operating officer has left her role, with Damien McCallion due to be appointed on an interim basis. Back within Miesan Plaza, assistant secretary Fergal Goodman has retired, and Stephen Donnelly’s private secretary has moved to another position.

The press office has been reformed – former Labour Party general secretary and HSE deputy head of communications David Leach has been seconded over as head of media relations, in a move said to be favoured by both Minister for Health Stephen Donnelly and the department's new secretary general Robert Watt.

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Part of this is driven by the natural rhythms of the civil service – people stayed in position due to the pandemic, which meant internal moves or retirements were stalled.

However, there are long-standing issues within the Department of Health, seen by many as the most pressured and politically charged place in the civil service. It is, an official says, “a department that doesn’t have any time to be strategic”.

A departments veteran says that “politically and administratively, people don’t get the time and space to do what they want”.

Drawing a line from past scandals like CervicalCheck to the current controversy over the location of the National Maternity Hospital (NMH), a senior figure bemoans the "opportunity cost" of firefighting.

“The NMH, even if that gets resolved politically you’ll just be back to where we were a couple of years ago, nothing new has been built, a huge amount of time has been expended to stay where you are.”

Watt was given a mandate to shake up the department, and is said to be planning a new structure to be introduced next year which will change the responsibilities of different management board members, while efforts are underway to mine opinion on departmental culture from officials themselves.

A raft of new officials have been drafted in from across the civil service, and more senior positions will open up as part of the reformation effort.

However, Watt's style and the circumstances of his appointment have also proved a lightning rod – his pay generated reams of coverage, while the controversy over the departure of Sláintecare programme chief Laura Magahy, and the cancelled appointment of Holohan to a secondment in Trinity College have seen him and others hauled down to Oireachtas committees.

This is a fact of life in the department, says a third official: “It’s a tough place to work, it’s intense, there’s a lot happening all the time – you try to do something and you end up in front of a committee.”

Covid meant that dynamic was put “on steroids” for two years. Add in the secret taping of officials and the minister, and publication of the transcripts, and it has been a tumultuous time.

Senior figures bemoan that Holohan’s botched appointment had its roots in a failure to “square off” the appropriate people, which led to a loss of political support and what some derisively refer to as “media hysteria”. While some officials believe that the outgoing chief medical officer feels bruised, sources close to Holohan insist he bears no ill will over the episode, but is disappointed that the opportunity has evaporated.

He has indicated he intends to leave the department as planned in July, and colleagues say he will take time over summer before deciding on his next steps. Glynn, meanwhile, was also the object of media scrutiny, but his camp has argued this didn’t condition his decision to leave to take up a role with consultants EY.

It seems unlikely that many more celebrity civil servants will be poached – one could argue there aren’t any left. But as a post-pandemic future beckons, tackling decades-old inertias will bring its own challenges.