HSE decks cleared for new regime

BACKGROUND:Cathal Magee steps down as James Reilly prepares to announce overhaul plans for health service

THE DEPARTURE of Cathal Magee as chief executive of the Health Service Executive effectively clears the decks of most of the senior administrative figures in the health area who were in place when Minister for Health James Reilly took over from Mary Harney.

Shortly after his appointment in March of last year, the Minister removed the politically appointed board of the HSE.

It was replaced by senior civil servants and health service officials.

In May last year, Jimmy Tolan, the chief executive of the State- owned health insurer VHI, stepped down following reported disagreements with the Minister over plans to break up the company.

Several weeks ago, the chairman of the VHI, Bernard Collins, announced he was leaving his post at the end of the summer. Curiously the Department of Health would only offer a “no comment” when asked if the Minister had sought the resignation.

Earlier this year, the secretary general of the Department of Health Michael Scanlan announced his retirement.

He was replaced by a former senior health board official and registrar of the Pharmaceutical Society of Ireland Ambrose McLoughlin.

However, it is the departure of Magee, a former Eircom executive who has three more years to run on his €300,000 annual contract, which is likely to generate the most comment.

The timing of his departure comes as the Minister is to make announcements regarding sweeping changes to the governance structure of the HSE.

The existing management arrangements are to be replaced by a new system of directors. The organisation will be headed by a director general.

However, there appeared to be no guarantee that Magee would secure the new top post in the organisation.

Asked last year about the future role of the chief executive, Reilly said nobody would have to reapply for their own job.

However, when pressed, he said it would be open to Magee to apply for a directorate post if he so desired.

The Minister denied that effectively, Magee’s job was being abolished.

“He has a job, that job remains. He has a contract and that contract remains.”

Over the past year, however, Reilly has made no secret of his impatience at times at the HSE.

For example, last May, shortly after his appointment, he publicly maintained that the health

service had used €100 million assigned to finance the Fair

Deal nursing home support scheme for older people for other purposes.

Tensions at the top of the health service have increased over recent months as the budget deficit increased.

A recent board meeting in the Department of Health, which considered how the deficit had escalated to €281 million, was described as “very tense”.

The Minister also in recent weeks appointed a consultant from the UK to examine the capacity of the HSE to manage its €13 billion budget.

Magee, for his part, has argued that the financial overrun is not all the fault of the health service.

At a recent meeting of the Dáil Public Accounts Committee, he pointed to the failure of the Department of Health to deliver on a promised deal on reduced drug prices and on legislation to increase revenue from health insurers.

He has indicated that these issues, along with a larger- than-expected number of staff leaving the organisation in recent months, were driving forces behind the deficit.