Ex-Sláintecare chief raised concerns about issues ‘contrary’ to programme prior to exit

The former executive director of the Sláintecare health reform plan raised concerns about issues that ran “directly contrary” to the programme months before she resigned.

Emails reveal that Laura Magahy, who quit last September, contacted Department of Health secretary general Robert Watt in June after reading the minutes of a meeting between the Health Service Executive and Minister for Health Stephen Donnelly.

Ms Magahy emailed Mr Watt saying that if what was stated was correct, it ran “directly contrary to the Sláintecare 3 year Action Plan recently approved by Government”.

“The action plan contains the reform priorities and key enablers for the next three years which will necessitate HSE’s full implementation cooperation – is HSE being asked to consider alternative reform priorities and enablers?”

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The minutes also referred to a pause to the creation of regional health areas (RHAs), a key part of the reform agenda. In response, Mr Watt said the HSE “have doubts” about the RHA proposals.

She said a business plan on these had been due to go to the HSE for consideration before going back to Government for approval.

“Are we to stand this work down?” she asked.

Slow progress in the implementation of regional health areas was among the factors cited by Ms Magahy when she stepped down in September.

‘Not entirely accurate’

The exchanges, which were released under the Freedom of Information Act to Sinn Féin health spokesman David Cullinane, show that Mr Watt sought to ease Ms Magahy's concerns, saying the minutes were "not entirely accurate".

“Everybody is focused on delivering on [Sláintecare], [there] is no issue here – but sequencing is a challenge.”

He said, however, that the HSE “have doubts about this RHA measure” and would reflect on it further.

Ms Magahy responded, saying the regional health areas “are an absolutely fundamental requirement for reform”.

“Arguably they should be the first thing to be done, and everything else sequenced around them”. She argued they would facilitate reforms in a wide variety of areas – “everything we need to reduce and get accountability for waiting lists”, she said.

‘Well founded’ fears

Mr Cullinane said it was “clear” that the department was seeking to reshape and reform regionalisation to ensure minimal change and keep control at the centre of the health service. “It seems the fears expressed by key Sláintecare officials who resigned were well founded.”

The HSE and department have said implementing the regionalisation project was delayed due to the pandemic. A memo on regionalisation for Government is promised “shortly”, said the department, adding that it is “committed” to it.

A HSE spokeswoman said the organisation is “completely committed” to major reforms, including regional structures “which are an essential part of the future”. She said the HSE is working to develop a model for RHAs and expects a impelmentation plan to be finalised this year.