Four years after picking his reform team, three of the five advisers Prof Drumm chose to be at his side have taken flight, leaving many to wonder if things just got too hot in his 'kitchen'. EITHNE DONNELLAN, Health Correspondent, reports
IN JUNE 2005, shortly before Prof Brendan Drumm took up his job as chief executive of the Health Service Executive (HSE), he revealed his plan to bring his own handpicked “reform team” with him to the organisation and met with significant resistance.
People in the system needed convincing that his team was not taking their jobs, he said. Other managers would be too busy, he claimed, to drive the reforms, and this was why he wanted his own team.
The team he wanted to take to the HSE at that time included Maureen Lynott, then director of the National Treatment Purchase Fund; Dr Seán McGuire, a Carlow GP with experience in setting up GP co-ops; John O’Brien, then chief executive of Dublin’s St James’s Hospital; Tommie Martin, then of Comhairle na nOspidéal; and Karl Anderson, a communications consultant.
In the end he got his way and the five people he had named for his so-called “kitchen cabinet” before he took up the job in August 2005 joined him when he became HSE chief.
Three of them – Ms Lynott, Dr McGuire and Mr Anderson – signed contracts which entitled them to earn up to €1,500 a day while the other two – Mr O’Brien and Mr Martin – were seconded from posts in the health service, and were paid salaries of about €171,700 a year.
But now, four years on, three of the five person team he chose to be at his side have taken flight, leaving many to wonder if things just got too hot in Prof Drumm’s “kitchen”.
The first to go was Dr McGuire, recruited to advise Prof Drumm on developing primary care services. He left in early 2007 to take up a job with Touchstone, a private company which was also working on the establishment of primary care centres across the State.
While the HSE claimed at the time he had completed his assignment, this clearly was not the case.
The 2001 primary care strategy, albeit published before Prof Drumm took over at the HSE, promised 600 primary care teams would be set up by 2011. Prof Drumm, charged with implementing it, confirmed last month that 127 teams were holding clinical team meetings at the end of August.
Dr McGuire himself maintained when he left that while he had a contract that would have allowed him stay for five years, his role in kick-starting back to life the primary care strategy was complete.
Next to desert the “kitchen cabinet” was Tommie Martin who had been given the job of director of the office of the chief executive of the HSE.
He took leave from the HSE shortly after an incident outside a pub near HSE offices in Parkgate Street, Dublin, in July 2008 during which another of Prof Drumm’s handpicked team – Karl Anderson – sustained a broken arm. Mr Martin subsequently retired.
And last week it emerged John O’Brien was leaving the HSE, having decided to retire. The announcement came within weeks of him being appointed by Prof Drumm to head up a team that would ensure greater co-ordination between the three Dublin children’s hospitals.
On October 7th Prof Drumm announced at the Oireachtas health committee that Mr O’Brien had been given this key role. Three weeks later when questions were asked about what seemed like his sudden decision to depart the organisation, the HSE, in a statement, said he “had been contemplating retirement for some considerable time”.
Soon after he joined Prof Drumm’s reform team, Mr O’Brien took on the role of director of the HSE’s national hospitals’ office, but he became the centre of controversy in 2007 during the Portlaoise breast cancer misdiagnosis scandal when he revealed at an Oireachtas committee that breast ultrasounds on 97 women who attended Portlaoise hospital were being reviewed.
At the time it was only known that 3,000 mammograms were being reviewed. The 97 women, Minister for Health Mary Harney, the Department of Health and Prof Drumm were unaware of the ultrasound review before his disclosure in public at the health committee meeting.
Attempts to contact Mr O’Brien for comment on his departure from the HSE failed this week. The HSE said he had retired at the end of October, so we would need to contact him outside of the HSE. A message was left for him on his mobile but he did not respond.
Meanwhile, Prof Drumm’s other two advisers – Ms Lynott, who advises the HSE on performance measurement and value for money and was involved in the negotiation of new contracts with consultants, and Mr Anderson, who advises the HSE on communications even though the HSE now has its own national director of communications – are still in their posts.
Given that all five of his cabinet were taken on as a “reform” team, questions are now being asked about where the departures of three of them leave the reform process.
The HSE said Prof Drumm had no comment to make on the fact that he was now left with just two of his original team.
Fine Gael’s health spokesman, Dr James Reilly, said it was blindingly obvious that there hasn’t been any real reform of the health service.
“I think it’s a reflection of the inability of that team to reform things and a reflection on Prof Drumm himself,” he said. “I think the whole HSE adventure has been a nightmare for the public because it was mismanaged from the outset, and Prof Drumm can’t be blamed for that because it was politicians refusing to bite the bullet on redundancies when health boards were merged,” he added.
Furthermore, he said, one only had to look at the increased number of delayed discharges in hospitals, the increased number of hospital cancellations and the continuing problem of patients having to spend hours on trolleys in hospital emergency departments, as well as the recent cancer misdiagnosis scandals, to determine if the HSE had been a success.
Labour’s health spokeswoman, Jan O’Sullivan, said questions had to be asked as to why the advisers were all leaving.
“Is there a sense that they weren’t able to achieve what they set out to achieve? While they’ve had some successes, I think overall the health service has got more costly in terms of the way it’s run and I don’t think it has achieved the sort of streamlining and efficiency that was expected when the HSE was set up in the first place,” she said.
She added that now that Prof Drumm had also indicated he himself would be leaving at the end of his five-year contract next August, there was a certain vacuum.
“I think in any organisation when you know somebody is going, they don’t have the same power to motivate people and to lead people and I think there is a vacuum now. I wouldn’t consider it to be a huge problem that these key people were going after five years if the organisation had achieved what it was expected to achieve in those five years,” she added.
The fact that most of the “cabinet” left during Prof Drumm’s term, however, was surprising. “I think it’s worrying because I think it suggests that there isn’t a sense that they are achieving their goals. If they were, I think they would be more inclined to stay with the organisation,” she added.
Prof Drumm claimed though when he appeared before the Oireachtas health committee last month that considerable reform had been achieved. He stressed that since the HSE’s transformation programme began in 2006, Ireland had moved up 15 places to 13th out of 33 countries in the annual Euro Health Consumer Index Report. He added that that report had said “the creation of the Health Service Executive was obviously a much-needed reform”.
He also stressed that performance at various levels within the organisation was now being measured and managed, and figures in its monthly performance reports, which are published regularly on the HSE’s website, showed that year on year the number people waiting over six months for inpatient care was down by 15.5 per cent and that staff absenteeism, which at the beginning of the year stood at 5.96 per cent, was down to 4.96 per cent at the end of July.