Prospectus chief in battle for healthcare reform

David W Duffy got the chance to put his strategy skills into play during his six-month stint as a semi-professional rugby player in France following university. Two decades later, the Trinity College business graduate is the managing director of Prospectus, Ireland's largest independent strategy consulting firm.

Although his interest in rugby remains strong - he is vice-president of the 152-year-old Dublin University Football Club - Duffy's main game these days is winning more work for the firm he founded in 1991.

Dublin-based Prospectus has developed strategies for companies including FBD, Dairygold, Friends First, AIB, Bank of Ireland and the ESB.

At present the firm is seeking suitable buyers for Mount Carmel Hospital in Dublin on behalf of the Sisters of the Little Company of Mary. It is only one of a series of high-profile projects it has been engaged in recently. The firm also helped Danone transfer its cash management function from Paris to Dublin so the French food maker could avail of lower tax rates.

Prospectus won the Danone project, which it completed in April, through its collaboration with the Eurogroup Consulting Alliance, a network of independent consultants in nine European countries.

Although Prospectus employs just 17 consultants, it has access to Eurogroup's 800 consultants and their expertise. "Danone came to us instead of an established player like Deloitte," he says. "They didn't think a large company would worry as much about the project as a small company. The IDA were pleased as there isn't really a history of French firms coming to Ireland and it will make it easier to win more work from France."

Prospectus's biggest achievement to date, though, was advising the Department of Health two years ago on the abolition of 11 health boards and the creation of the Health Service Executive, according to Duffy.

"We concluded that so many health boards were not a good idea and that Ireland needed a unified structure," he says.

"It was politically challenging, as we had to get the Government to accept our recommendations, especially with all the politicians on the health boards. Our achievement was in persuading the Department of Health it was the right thing to do and persuading a number of ministers it was the right thing to do."

He adds: "There is now only one buyer - the HSE - whereas before we had 11 buyers. The HSE now looks for value for money for everything, from paper clips to drugs, so it can get synergies in purchasing."

Although Prospectus had been involved in healthcare for 10 years, the high profile and controversial review of the health-board system helped to make it a leading player in the healthcare strategy market, says Duffy. Prospectus subsequently won more work from the department. It developed policy guidelines in February on the creation of private facilities at public hospitals.

The private sector will inject a lot of capital into public healthcare, create a momentum for completing projects and lead to a focus on value for money, Duffy believes. He also expects more private healthcare companies will treat minor injuries and basic matters, freeing up space in public hospitals. He cites the opening last year of a walk-in urgent care clinic in Dundrum run by the VHI and private medical company The Well.

"We are in a period of learning here as to how the private sector will work with the public sector," says Duffy. "We see the private sector providing more non-acute services, and see people with no background in healthcare, such as logistics companies, getting involved."

Prospectus is also focusing on strategies for healthcare and health research because it expects it will become an important part of the Irish economy.

For Forfás, it reviewed how Ireland could exploit investment in health research in hospitals and universities for the benefit of economic growth, and it has conducted a feasibility study for the IDA on the creation of a medical research laboratory in Ireland by a US multinational.

Ireland has increased its spending on research and development to €1.79 billion in 2004 from €856 million in 1997, according to Forfás.

"People don't think of health as a sector, or what it adds to GDP, like they do about the financial services sector," says Duffy. "If we were to think of ourselves as a healthcare island, we could do something special. We could have a position in Europe as a reformed healthcare system with private-public co-operation."

While most of Prospectus's clients are large organisations in the private and public arena, it has also been hired by voluntary organisations such as the St Vincent de Paul Society and the Carmichael Centre, which is Ireland's largest shared facility for charities.

Duffy, who holds an MBA from IMD in Lausanne, Switzerland, has gained an insight into the voluntary sector through his chairmanship of Miss Carr's Children's Home on Northbrook Road, Dublin. The home cares for children needing support when their parents encounter problems with the law or drug abuse. It also has small flats for single mothers. "There is an enormous need for these flatlets - we could do hundreds," says Duffy.