Sir, – The suggestion by Dr David Tansey (Letters, January 18th) that the HSE focus “laser-like” on four key areas that demand urgent change – the rollout of a national universal electronic patient records in every hospital, a national universal patient identifier for every patient, a national universal radiology and bloods system for every HSE hospital, and a national universal payroll system for the entirety of the HSE – brought to mind two recent issues. One was the prescient observation by Fintan O’Toole that HSE staff divide into four groups – “enthusiastic, chastened, cynical and burned out” (Opinion & Analysis, January 10th). I thought it was great to see an experienced doctor still in group one. It thus briefly brought to mind Christmas, and those who still believe in Santa Claus. Long may his optimism continue, I thought, rather patronisingly. It is much needed.
However, a follow-up letter appears to assume that such changes might be straightforward. Ben Dundon describes the introduction of a universal payroll system for the HSE as “the easiest” of the four reforms (Letters, January 20th), finding it “incredible” that it’s not already in place. Thus it’s fair, and probably necessary, to point out how such interventions actually play out.
The project known as Ppars (personnel, payroll and related systems) was originally allocated a sum of €9.1 million, in the budget of 2001. This was in order to introduce a nationwide structure for such purposes across the HSE, delivered over two years. Its mention is now usually accompanied by the word “fiasco” or “debacle”. By the time it was abandoned, well over €150 million had been spent while it never came to cover even a quarter of employees. Management consultants were paid tens of millions. A report on the project, asking if such a thing could happen again, not only found that it could, but that it “probably has” (“Ppars fiasco could happen again, says report”, News, March 4th, 2006).
The document, rather remarkably, also echoes opinions on the letters page about HSE oversight this week. Peter Declan O’Halloran and Gerry Christie comment on the paradox of legions of managers juxtaposed with a “lack of leadership” in the executive body (January 18th and 20th).
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The Ppars report referred to above, by Dr Joe McDonagh of Trinity College Dublin, as relevant now as in 2006, stated that “no amount of project management will fix a leadership deficit”.
Unfortunately I suspect Ben Dundon is literally correct. This probably was among the easiest of the many reforms necessary. But it still may be beyond us. Whether enthusiastic young doctors simply read about, or we collectively get to relive this history, it is fair to say that working through endeavours like Ppars are the events that move us HSE workers along the dispiriting continuum Fintan O’Toole so eloquently described. – Yours, etc,
BRIAN O’BRIEN,
Kinsale,
Co Cork.