Reilly backs comments over health service dysfunction

THE MINISTER for Health has said that the “large corporate structure” in the Health Service Executive is clearly dysfunctional and has been for some time.

Dr James Reilly drew distinctions yesterday between the “corporate structure” and the 50,000 doctors and nurses and those working on the frontline for the HSE who, he maintained, were delivering excellent care in difficult circumstances.

The Minister fully backed the strong criticisms of the HSE made by one of its own most senior managers in an address in University College Dublin in June. A tape of this address was broadcast by RTÉ yesterday.

In the address to social workers and academics, the head of the HSE’s child and family services, Gordon Jeyes, described the culture in the organisation as “appalling”. He said a textbook could be written about the HSE. “If it was possible to get it wrong, they got it wrong.”

He added: “I see no sense in too many parts of the HSE of customer-orientation, of a professionalism that is evidence-based, theoretically grounded, clear in its values and on the side of the public and, in my instance, on the side of the children.”

Speaking on the RTÉ radio This Week programme, which obtained the tape of the address, Dr Reilly backed the concerns raised by Mr Jeyes about the HSE.

He said the Government was extremely concerned about the HSE before it came into office and had said it was going to abolish it.

He said there were in effect two organisations within the HSE, one being the 50,000 or so doctors and nurses and those on the frontline who were delivering excellent care. There was also the “large corporate structure” that was clearly dysfunctional and had been for some time.

“I agree with everything he [Mr Jeyes] says about that and we are seeking to change that,” he said.

In the tape of the address delivered in UCD, Mr Jeyes also made criticisms of members of the Cabinet who, he contended, believed that legislation on mandatory reporting of child abuse was all that was needed to deal with that issue.

He also described the Government’s moratorium on recruitment in the public service as “daft”. He spoke of the “grief” he had experienced in his discussions with officials of the Department of Education. He said that daily he had to confront the possibility of failure.

Mr Jeyes also suggested that while the Government had established a new Department of Children, there was no detailed plan beyond that.

However, in an interview on the programme yesterday, Mr Jeyes appeared to change tack on this issue and said that there was now “a general sense of direction” of a plan. He also said that the Cabinet was committed to child protection.

The Minister said that he was not aware of anyone in the Cabinet who believed that legislation on its own would change anything, per se, especially in the area of childcare.

He also said that the moratorium on recruitment would not be lifted but it would be applied more flexibly.

The Minister described Mr Jeyes as a “straight-talking guy [who is] very concerned about the safety of children and is impatient for change, as the Government are”.

In a statement, the HSE said: “The HSE has seen only snippets of this transcript. It would be necessary to see the entire document and to talk to Gordon – who is abroad currently – in order to put his comments into full context prior to drawing any conclusions on this matter.”