HSE sought to omit details on performance

Top-level management accused of trying ‘to disguise full facts’ about level of crisis

HSE director designate Tony O’Brien (near side) alongside Minister for Health James Reilly. Earlier this year, Mr O’Brien suggested a “significant streamlining” of the often embarrassing information it publishes on a monthly basis about waiting lists and financial overruns in the health service. Photograph: Cyril Byrne
HSE director designate Tony O’Brien (near side) alongside Minister for Health James Reilly. Earlier this year, Mr O’Brien suggested a “significant streamlining” of the often embarrassing information it publishes on a monthly basis about waiting lists and financial overruns in the health service. Photograph: Cyril Byrne


The head of the Health Service Executive proposed providing key information about the performance of the health service directly to the Department of Health instead of releasing it to the public, letters seen by The Irish Times suggest.

Earlier this year, HSE director designate Tony O’Brien suggested a “significant streamlining” of the often embarrassing information it publishes on a monthly basis about waiting lists and financial overruns in the health service. As part of this, he asked department secretary general Ambrose McLoughlin which information the department wanted included in monthly performance reports, which are published online, and which information should be sent directly to the department.

Sinn Féin health spokesman Caoimhghín Ó Caoláin said the correspondence showed the top levels of the HSE and the department were attempting to "disguise the full facts" about the true level of crisis in the public health service brought about by Government cutbacks.

Supplementary report
However, a HSE spokesman said there "wasn't much" to the issue and insisted that no additional information was being omitted from the published information and sent to the department. Some information has been moved from the performance report to a supplementary report, he said, but this was also published.

A department spokesman said it told Mr O’Brien in a reply that the performance report should be retained in its existing format with all information retained “as heretofore”.

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Each month, the HSE board approves the publication of a monthly performance report on the health service, drawn up from information provided by its finance, human resources, hospitals and primary services divisions. Invariably, and to the concern of senior management in the HSE and the department, it provokes a flurry of media stories about long waiting lists or financial problems within the health service.

In the letter sent last January, Mr O’Brien referenced “previous discussions” about the monthly performance reports and “the desire to make changes in its format for 2013”.

He said it was his intention to "significantly streamline" the document so that it gives "a more focused summary" of the key performance messages in a manner "more appropriate for public communication".

'Submitted directly'
He added: "There will of course be a requirement for further reports both for internal management use and also for the officials in the Department of Health". Mr O'Brien then asked Dr McLoughlin's view on "the information that needs to be retained in the published Performance Report and that which your Department needs to receive from the HSE on a regular basis but which might in future be submitted directly to your Department rather than in the Performance Report".

Mr Ó Caoláin said it was long the case that the top levels of the HSE and the department had made determined efforts to disguise the true level of crisis in the health service.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.