In the early 1990s a young physiotherapy student from Trinity College Dublin, Anne Coyle, began an internship at Beaumont Hospital. It was a relatively new hospital at the time, serving the northside of the capital. Now Coyle has returned, this time as the hospital’s chief executive officer – and her role isn’t the only thing that has changed in those intervening years.
“[Beaumont] is serving a much larger catchment area. It’s serving a much more complex population than it did when it was built 40 years ago,” she says.
The hospital has a sizeable footprint, with almost 5,000 staff across 54 medical specialities, as well as more than 62,000 attendances to its emergency department (ED) every year. More than 28,000 inpatient admissions are carried out annually, as well as more than 71,000 day procedures. One of Ireland’s major academic hospitals, it is partnered with the Royal College of Surgeons in Ireland (RCSI).
Coyle started her new job at the end of August, describing it as a “full circle” moment. Before that she was chief executive of Mercy University Hospital in Cork, having previously worked at senior management level in the UK’s National Health Service (NHS) since 1997.
‘We bought our son a flat in his name but we took the rental income’
Matt Cooper: I’m an only child. I’ve always been conscious of not having brothers or sisters
‘It’s kind of become our daughter’s cheat meal’: The view on new hot school meals programme
New government: Strong expectation of several promotions and new portfolios when cabinet is announced
There are many things she hopes Beaumont will achieve. Its new five-year strategy, entitled Building Excellence in Care, was launched recently. Does she believe the care on offer is already excellent? She admits there is room for improvement in some areas, particularly around capacity and overcrowding.
The Health Information and Quality Authority (Hiqa), the watchdog that inspects healthcare facilities to ensure safe and effective care is being delivered, conducted an unannounced inspection of the hospital in September, weeks after Coyle took up the role. The inspectors found that the overcrowded conditions in the ED created a “challenging environment” that did not respect the dignity or privacy of patients.
“ED overcrowding is sort of a multifaceted problem. And since I have started, we have been doing a lot of work internally on our escalation processes, on the processes making sure that nobody [aged] over 75 waits, managing our flow, managing our support, and getting people access to a bed as quickly as possible,” says Coyle.
“So there’s definite work to do there, and some of that [involves] improvements that we need to make as a hospital.”
She says some of these improvements will require work with Beaumont’s partners, step-down facilities and the primary care system.
However, she acknowledges that the physical infrastructure of the hospital accounts for a certain amount of the challenge ahead. There are plans to change this.
[ HSE to put in place nearly 300 additional hospital beds under new service planOpens in new window ]
Application for planning permission has been made to develop a new ED; it is envisaged that it will triple the current size . There are also plans for 95 new beds in a new ward.
“But the building itself, in terms of how it is laid out, I think that’s a whole other debate because we do need, definitely ... new buildings,” says Coyle.
“But there’s also [the question of] how do we repurpose what we have currently got? How do we organise ourselves?”
The way in which care is delivered has changed significantly in the decades since the hospital was built, with more care delivered on an outpatient basis, says Coyle.
“So how do we zone the hospital as effectively as possible?”
So too have people’s needs and the demand on services changed. Beaumont met its target for service delivery last year, she says, but there could be difficulties in the future.
“The demand is continuing, so our activities are not necessarily keeping to the pace with that demand. So it will be challenging around how we deliver, against the targets for 2025,” she says.
In healthcare, she says, the goalposts constantly shift. “It keeps the job quite interesting. But yes, it can also feel a little bit frustrating, in so much as it’s never ‘done’.”
As is the case in the health service throughout the State, digitisation is an area that staff at Beaumont are seeking to progress. When the hospital opened, Coyle says, it was “really advanced”, having been provided with what was called the Beaumont Health Information System.
However, technology has moved on; the system has been deemed the “biggest risk” to delivery of services at the hospital and is being replaced by an up-to-date version.
The HSE’s Dublin, North East region, where Beaumont is located, “will be the pilot site for the electronic patient record, and that will sit within the framework of the Digital for Care programme”, says Coyle. “That allows us to make sure that we move away from recording on paper ... and that improves our accuracy and diagnostics and recording of that information and freeing up our clinical staff to deliver clinical care.”
Coyle stresses the importance of people “being able to have that access to our own information” in digital form, “because it’s our information”.
As someone who worked in the NHS for many years, Coyle is acutely aware of the differences between it and the Republic’s health system. There are benefits in the HSE’s provision of health and wider care services; the NHS, she says, is further along regarding digital healthcare and “continuum of care”, meaning the support provided to patients pre- and post-discharge.
The biggest similarity, in her view, is the “excellent quality” of clinicians.
In March 2023 the Government rolled out the public-only consultant contract, which seeks to remove private work from the public health system and increase the number of senior decision makers in hospitals on evenings and weekends. Some 78 per cent of consultants in Beaumont have signed up to the contract, Coyle says, which has “increased opportunities” for six-day working weeks and longer hours.
Concerns have been raised about how this might be achieved, but Coyle says it’s a case of testing it, in the first instance, and working through any issues.
The NHS recently moved to working across the seven days – is this something that should be implemented in the Republic?
“It ensures no gaps, really – that you don’t have a period of the week where you are not working and delivering your full range of services,” says Coyle. “But I think at the six [days], we should work that through and be really clear there’s no unintended consequences of undertaking that. Because it’s making sure the infrastructure is there in terms of your diagnostics, in terms of your labs, in terms of your health and social care professionals. It’s the whole team that sits around your consultants.”
Beaumont recently came under scrutiny when the Irish Kidney Association took legal action against it for not returning a building owned by the charity after the hospital borrowed it more than four years ago during the Covid pandemic. Coyle says the building was returned in November, but that the matter is “still subject to legal proceedings”.
Though she is relatively new to the chief executive role, she is ambitious in her plans. Ireland’s growing and ageing population brings with it unique challenges: complexity of illnesses and increased co-morbidities. It is important, therefore, Coyle believes, to plan not just for the now, but for the future.
“As we develop our new buildings, it’s [a case of] designing them with regard to people’s needs as they stand in 2026 but also down the line,” she says. “And as we get new treatments for conditions that are problematic at this moment in time, to continue to future-proof the buildings that we develop.”
- Sign up for push alerts and have the best news, analysis and comment delivered directly to your phone
- Join The Irish Times on WhatsApp and stay up to date
- Listen to our Inside Politics podcast for the best political chat and analysis
