THE LACK of integration in the HSE has come in for stinging criticism from its new chief executive Cathal Magee in his first annual report. Mr Magee also finds that the financial and service information systems in the organisation “are not fit for purpose”.
In the organisation’s latest annual report, published last night, he refers to the fact that the executive was an amalgamation of 17 different bodies and has absorbed a further eight bodies since its formation in 2005.
“Today, five years on, it still largely resembles a federation of former autonomous entities, rather than a coherent single integrated organisation model with a shared identity and mission,” he says.
“While many important changes and improvements have taken place, the necessary infrastructure in terms of organisation design, service information and enterprise systems, management capabilities and processes are not in place to support the effective integration and leadership of such a large and complex enterprise,” he adds.
Mr Magee also says “a legacy administrative culture still prevails” in the executive “reinforced in recent years through the highly centralised and rigid public service control. It is seriously out of line with the requirements, the demands and challenges of a dynamic 24/7 operating environment.
“Changing this environment will require major investment in re-engineering virtually all components of this legacy infrastructure.”
He says there is an opportunity to shift the system to a next generation technology-led, smart healthcare infrastructure to support health and personal social services over the next decade.
His comments come in the midst of plans by Minister for Health James Reilly to abolish the organisation. Dr Reilly has already removed the HSE board.
The annual report shows the executive balanced its budget last year and returned a surplus of over €18 million to the exchequer. The report says it is almost impossible to achieve an exact break-even position on an overall budget of €14.4 billion. The report says the surplus to be surrendered amounted to “less than 0.17 per cent of the total net vote of the HSE”.
The report shows the outgoing chief executive Prof Brendan Drumm was paid €51,238 in lieu of annual leave which could not be taken when he departed last year.
In addition it shows Revenue audits found underpayments of PAYE, PRSI, VAT and other taxes, giving rise to tax, interest and penalty settlements with Revenue totalling €3.35 million in 2010.
Internal audits of a number of consultancies revealed that vendors were paid €3.2 million over a number of years in respect of services for which no competitive procurement processes were conducted.