Top-up payments to hospital managers

Sir, – The current feeding frenzy with regard to the remuneration of hospital CEOs is not easy for health professionals to understand. The CEO of a large hospital is responsible for the utilisation of a budget of perhaps €200 million. He or she has to execute board and policy directives covering hundreds of complex interlocking activities relating to safe patient care. The simplistic neo-liberal business approach to health care has led to a focus on costs and targets at the expense of optimal patient care and indeed compassion. The CEO of a €200 million business is concerned with profit and loss. He or she is unlikely to face management decisions that are even remotely as challenging as those facing a hospital CEO who is responsible for the complexities of patient-centred and coordinated health care as well as finance.

At the same time our hospital CEOs are expected to deliver more efficient and safer care with shrinking resources. Do we or do we not want people of the highest competence to deliver health care to our loved ones? Pay peanuts, etc. – Yours, etc,

IAN GRAHAM,

Rocky Valley Drive,

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Kilmacanogue, Co Wicklow.

Sir, – Earlier this month the chief executives of four major hospitals, including Crumlin children’s hospital, wrote to the HSE to warn it that health cuts were starting to threaten patient safety. Prof John Crown commented at the time that it was “extremely significant that the CEOs would put their necks out” as they would “tend to see themselves on the same side of the power equation as the HSE and the Department of Health”.

Fast-forward to this week, and in a move that would surely have Sir Humphrey purring with approval, the Department of Health just happened to release scandalising top-up payments relating to, among others, the CEO of Crumlin hospital. Regardless of the issues in regard to breaches of pay policy, I would say the department has made its policy on necks and parapets abundantly clear. – Yours, etc,

DONAGH McTIERNAN,

Lakepoint, Mullingar,

Co Westmeath.

Sir, – It may help to put these figures into perspective to note that the basic salaries of many senior hospital executives are only marginally higher – in some cases lower – than what the High Court recently ruled were the minimum expenses of a bankrupt person. – Yours, etc,

PATRICK NOLAN,

Cherbury Gardens,

Booterstown, Co Dublin.

Sir, – As good Christians, should we not accept that this is the Lord’s will. Mark 4:25 “Whoever has will be given more; whoever does not have, even what they have will be taken from them”. – Yours, etc,

COURTNEY MURPHY,

Applewood Heights,

Greystones, Co Wicklow.