The Department of Health last night strongly rejected the latest public criticism of the slow pace of change in the health service from Prof Niamh Brennan, the author of a key Government report on health reform.
At two separate events during the weekend Prof Brennan was highly critical of the Department for its "slow and fragmented approach" to implementing change.
Dr Brennan, chairwoman of the Commission on Financial Management in the Health Service and professor of accounting at University College Dublin, said she did not believe health board CEOs and Department of Health officials had the skills to bring about the change required in the health service.
"We need outsiders with no conflict of interest to implement change," she said.
A spokesman for the Department of Health said, however, it strongly rejected Prof Brennan's criticisms.
"The Minister for Health will very shortly be announcing the membership of the Health Services Executive and the implementation group," he said.
Speaking at the Adelaide Hospital Society's conference in Tallaght, Co Dublin, on Saturday and to the Dublin Economic Workshop 26th Annual Policy Conference in the Sheen Falls Hotel, Kenmare, Co Kerry, yesterday, Prof Brennan said she could not see how by establishing 13 separate project groups, the Department of Health hoped to move the reform agenda forward.
"Just as our health services are highly fragmented (and are inefficient as a result) this seems to be a very fragmented approach to implementation," she said.
The Brennan report, published last June, recommended a fundamental overhaul of the health system, including the establishment of a central management system run by a new executive, rationalisation of existing agencies, and reforms to financial management and control.
Referring to her report's 136 recommendations, Prof Brennan said it identified 52 as suitable for immediate implementation.
Speaking to the Adelaide Society, she questioned how many of those immediate recommendations had been activated since the commission's report was presented to the Minister for Health seven months ago.
In Kenmare, Prof Brennan said that, while the Government had said it would accept some of the report, "it is completely silent on some recommendations and makes commitments in relation to others in such general terms that it is unclear exactly what is being planned in relation to specific recommendations".
She added: "This is of concern."
The Brennan report called for powerful figures to be appointed to head an implementation committee, which would hand over to the board of a new health service agency within two years.
The two-year time frame set out for the implementation by the 12-person Brennan committee "is reasonable", she said.
"Those who say it will take 10 years do not have the can-do,make-it-happen attitude that is required for successful implementation."
There was no evidence that an interim board of the new health service executive had been put in place, despite a statement by the Government in June that it would happen "shortly".
She said many of the 136 recommendations could not be implemented until the executive was in place.
"It is critical that the interim board be appointed immediately," Prof Brennan asserted. "In the meantime there is a risk that managements in the health boards may put in place entrenchment mechanisms that may make change more difficult."