Plan to reform management of midwest acute hospitals

THE HEALTH Service Executive (HSE) has admitted that staff morale is low and that there is no accountability structure for clinicians within its acute hospital network in the midwest.

The admissions appear in a HSE document proposing the overhaul of management structures in the midwest acute hospital network, which this year has a budget of €200 million.

As part of the overhaul the HSE is to establish a trust to oversee the operation of the six hospitals: Limerick Regional, St John’s Hospital, Ennis General, Nenagh General, the Maternity hospital and Croom Orthopaedic.

The strategy framework for the midwest is proposing the abolition of separate management teams for the hospitals. Instead, the hospitals are to be overseen by a single executive team along with four directorates.

According to the document, the new structure under one team will reduce wait times for access to services, reduce emergency department overcrowding and increase the involvement of clinicians in management.

A proposed new management team will report to the recently appointed chief executive Ann Doherty. The team will oversee four directorates in diagnostics, medicine, peri-operative and maternal/child care.

The document admits that in the current structure clinical governance is fragmented with no appointed leader(s) or accountability structure; that internal clinical governance has identified risks; that movement of staff between hospitals is seen as punitive; and that the hospitals have disparate practices, systems, processes, budgets, workloads and governance structures.

After a briefing with Ms Doherty, consultant obstetrician Dr Gerry Burke has described the proposals as “rampant managerialism” and guaranteed to fail.

The union Impact yesterday gave the proposals “a cautious welcome”. Assistant general secretary Andy Pike said: “We believe that a line needs to be drawn under the failed reconfiguration process which resulted in services being withdrawn from Ennis and Nenagh, with huge overcrowding then taking place within Limerick Regional.

“A strategy for the integrated development of services across all hospital sites in the region is welcome, and gives a sense of direction and purpose to what has become a demoralised service.”

He added: “This new structure provides for greater input from nurses, physiotherapists, social workers and other professionals, enabling decisions to be taken with input based on experiences of dealing with patients in the day-to-day front line.”

The executive team will report to an independent board.

Minister for Health Dr James Reilly recently announced Prof Niall O’Higgins as chair-designate of the Mid-Western Regional Hospital Group.

Mr Pike said arrangements for the transition into the new structures were now the subject of consultation between the HSE and the unions.