Paul Reid has a record of delivering big projects. Can he tame the HSE?
New HSE boss, who is seen as accountable, tough and innovative, faces a daunting task
‘He is a leader. He is prepared to take the responsibility and is not afraid of it.’ Above, Paul Reid, director general of the HSE. Photograph: Nick Bradshaw
To understand what Paul Reid is about, one needs to cycle back from his new role as director general of the HSE through all the senior management jobs he has held.
Go back almost four decades to 1980 and the start of his working life. He was 16, a working-class kid from Finglas in Dublin, a keen sportsman and fanatical supporter of the great Leeds United team of the 1970s. He left school and began work as a trainee installer in the Department of Posts and Telegraphs.
The job involved connecting landline telephones to homes and businesses and scaling up telephone poles on the roadside to run lines.
He began at the cusp of huge change that would turn the department on its head. The exchanges were being digitalised that year. Within a few years, the State-owned company Telecom Éireann was born, before ultimately being privatised as Eircom. The mobile revolution came along and eventually the venture capitalists came in.
Reid was a witness to that transformation during his 25-year career with the company. He saw it from both sides of the fence, first as a worker and later as a manager.
His own advance was two-pronged. He became active in the Communciations Workers’ Union, eventually becoming shop steward. He joined the Workers’ Party. Like many other prominent union officials of the time , he has since distanced himself from the party’s hard-left politics and is now pro-enterprise in outlook.
Separately, Reid also went back to education, studying at night. He was awarded a degree in industrial relations and personnel management from the National College of Industrial Relations. Later he did a business master’s in Trinity College Dublin.
His energy and toughness as a negotiator did not go unnoticed. He was poached by the other side. By the time he left Eircom in 2010, he was director of networks and operations. The company had been flipped three or four times at that stage. Like many other employees, Reid had also benefited from the employee share ownership plan, set up at the time of privatisation.
After his departure Reid worked for Trócaire as head of corporate affairs. A year later he moved to the Department of Public Expenditure and Reform as chief operating officer. His principal role there was heading the tricky pay negotiations that led to the Haddington Road agreement.
In 2014 he was appointed chief executive of Fingal County Council. He took over at the helm of the HSE this spring.
If you are looking for a pattern in the organisations to which Reid is drawn, it is this: they are large, long-established, highly unionised and publicly funded organisations in need of a radical overhaul.
His long experience in Eircom – from the lowest to the highest level, from the union side and the management one – gave him the perspective on how to do this.
“One thing that drives me is that I started at the bottom. I have a good sense of how big organisations work and a good sense of where change happens,” he has said. “It happens at the front line. Unless you bring local management into the change process, you will not succeed. Big strategic top-down change plans don’t work. You also need a bottom-up approach.”
Reid’s playbook is by now well-established. He sets out attainable goals for an organisation and focuses unrelentingly on them.
He is not combative in manner but can be very trenchant in his views. Soon after arriving in an organisation, there are always key changes in senior management, either through transfer or departure. He will also bring people in if he believes a particular skill set is missing.
Before beginning a new job, he consults widely, talking to as many people, at as many levels, as he can to get a handle on the issues and the problems.
Communication is also a big element of his style, both internally and to the media – in Fingal some councillors sensed he was better at the publicity game than the mayors of the county.
Engaging and open
When Reid was recruited to the Department of Public Expenditure and Reform in 2011, his big project was to secure a saving of €1 billion in the second round of public service pay cuts, leading to the Haddington Road agreement. It was a very difficult proposition, and one union, ASTI, rejected its findings.
“I have a vivid memory of union people saying to me how good he was, polite, engaging, open,” says one senior government figure from the time. “He is a leader. There is no doubt about that. He is prepared to take the responsibility and is not afraid of it. He conveys the attitude of getting something done.”
A senior public servant who has worked with him said he was “very strong on taking responsibility for things and not pointing the finger”.
Those who are off message don’t last too long. “He is never confrontational and will give everybody a chance to play in the band. But if they are not playing the right songs, you are out the door,” added the public servant.
Former INTO general secretary Sheila Nunan, who dealt with Reid during the Haddington Road talks, says he was very straightforward and honest. “He had good temperament and intelligence, was low key, not a man of high drama.”
She recalls he was driven by the need to get the agreement through; and was businesslike and creative in his approach as both sides tried to forge a difficult agreement.
The feedback from councillors in Fingal, where he moved in 2014, is almost entirely positive.
He went into the local authority with key goals. The first was to provide more housing. While not perfect, it is now one of the best-performing local authorities in the State. He put huge emphasis on economic development, ramping up the local enterprise office, forging stronger links with Dublin Airport and trying to improve the fortunes of towns such as Swords and Balbriggan.
Under Reid, St Patrick’s Day parades were reintroduced, huge support was given to the Flavour of Fingal food festivals and the Howth Prawn Festival and to two big plans in Swords: to conserve the castle and create a cultural quarter.
“He was very much across his brief form the start of his term,” says Labour councillor Duncan Smith. “He picked his priorities and was very good at delivering big projects.
“Generally he maintained close relationships with councillors. If a group had a divergent view, he would not be afraid to have a big row with them. Looking at the outputs, you cannot deny he had a positive impact.”
Another councillor, speaking privately, voiced a view that Reid did not tolerate disagreement too well. “He was very dominant vis a vis the council. If there were elements of the development plan or a vote against the council management he disagreed with, he would intervene and he would be quite vigorous. I felt he got political quite often.”
Another, also speaking privately, said Reid went through the management of the council like “a dose of salts” upon taking up the job. “He moved them around into different roles quite quickly, and there were a significant number of retirements following his arrival.”
The same councillor also pointed to his fixed views: “If he was questioned on anything, he got trenchant very quickly. He could get away with that in the council, where most councillors were relatively pliant. It might be different with the Oireachtas in his new role.”
Independent councillor Jimmy Guerin was impressed by Reid. “There is no doubt he brought a new vision and a sense of urgency to the role. He made his own stamp by putting in his own team. He had a hands-on approach, and was effective, including persuading councillors to hold on to the extra 5 per cent of the local property tax.”
Fianna Fáil councillor Eoghan O’Brien describes Reid as “a straight-down-the-line guy” and very much a positive thinker. “Soon after he started there were vacant units in Swords and a campaign to improve the town. He took time to walk the main street and call into business to get their views and ideas.”
Big health vision
Reid actively sought the HSE job. His term is is for five years and he is said to be determined to turn the health service around within that time. His template is Sláintecare. He has been on its implementation board for more than a year and sees it as the future.
The first big project will be to get co-ordination. At the moment there are nine community healthcare organisations across the State. They have responsibility for all the non-hospital services, including primary care, social care, mental health, health promotion, screening and vaccinations.
Then there are six hospital groups, clustered geographically.
The problem is the community healthcare organisations and hospital groups are not co-ordinated with each other. Their regions don’t coincide, and in some cases there are hospitals from the one group spread across a number of community healthcare organisations.
It is understood that Reid wants them fully integrated into six autonomous regional health organisations, with echoes of the old health boards. The HSE will become a much slimmed-down body with an overarching, supervisory and strategic role. The current unwieldy double layer of supervision involving the HSE and the Department of Health would also be radically changed.
“We are going to bring it back to local and regional and integrated,” says a person with knowledge of his thinking. There will be a central kind of oversight but it will hark back a bit to the old health boards.”
It is an ambitious aspiration. Going by Reid’s previous record, it may mean personnel changes in key areas where the most radical change is taking place.
Other changes during his term are likely to involve the rationalisation and centralisation of expert treatment in hospitals. A national trauma centre is one major project that will be advanced. This could involve approaching the thorny topic of reducing services in some smaller regional hospitals, which will invariably lead to substantial local political resistance.
Reid has all the knowledge, all the experience, from his days of climbing up telephone poles to his years as a boss. But it’s not going to be easy. Only time will tell if he can tame the HSE.