THE IRISH health service is overmanaged and under-led, an Irish doctor who turned down an opportunity to be the first chief executive of the Health Service Executive in 2004 said yesterday.
Prof Aidan Halligan, then the deputy chief medical officer of the NHS in Britain, decided at the last minute not to take the post.
He told a healthcare conference at Croke Park in Dublin that in years to come this generation in Ireland will look back and wonder why we didn’t have a better health service. “We should be ashamed of ourselves. It’s terrible really, it’s so sad,” he said.
He criticised the constant use of outside consultants and experts to draw up reports on what should be done with the system. “How do you change practice on a ward that is resistant? You don’t do a review. You don’t get McKinsey [consultants] in or KPMG . . . they charge a fortune and their reports are always impressive but it doesn’t change people’s behaviours.”
It was better, he suggested, to put in a “fly-on-the-wall nurse”, working with the staff for 72 hours, and then this person would tell you what exactly was going on.
He also indirectly criticised the new target-setting culture in health, pointing out that a nurse who spent hours hugging a man whose wife had died would be regarded as inefficient under this regime. “You see, when you’ve got targets that kind of thing is inefficient,” he said.
Prof Halligan, who is director of education at University College London Hospitals and is involved in a huge culture change programme in the NHS, said that since he became a doctor he treats everyone like they are his own relative.
“Why doesn’t the system do it? Why doesn’t the Government do it? Why don’t the people in charge of the health service see it that way? Haven’t they got families?” he asked. He added that it was not money or restructuring that would drive our health service but passion and vocation.
“You don’t need €17 billion. You absolutely don’t . . . you need leadership. You’re over-managed and under-led and you should get leadership from your frontline staff.” He said it took guts to lead.
Recalling the words of Martin Luther King, he said our lives begin to end the day we become silent about things that matter. “And there is such a silence in this country about healthcare. It’s extraordinary. It doesn’t matter what you see in the press. Why aren’t doctors and nurses, everyone rising up and putting the patients first?
“The hottest places in hell are reserved for those who in times of great moral crisis maintain their neutrality. Do something. Do it today. Do something different that will make a difference for a patient.”
Eilish McAuliffe, senior lecturer in health policy at TCD, called for a moratorium on externally- generated reports. She also said it had already been proven that changing structures in the health service did not work.
Liam Woods, HSE director of finance, said the HSE was potentially one of the most fulfilling places to work because it was fixing some of the most fundamental challenges that we face.