The appointment of Professor Brendan Drumm as the new chief executive of the Health Service Executive (HSE) is a positive indication that reform of our dysfunctional health service may finally be under way.
Issues that caused the collapse of negotiations on his contract two weeks ago have been resolved through the efforts of HSE board members and UCD. Professor Drumm will now take responsibility for 98,000 staff and a budget of €11 billion in mid-August.
A whole series of medical bush fires awaits action. But Professor Drumm has indicated his focus will be on the big picture. Rather than concentrate on politically-sensitive matters, like accident and emergency services in hospitals, he will seek to expand primary care treatment through a restructured GP system and better community services. Overcrowded A&E units are, he believes, a symptom of failure at primary care level.
In the past, there was a tendency by health boards to fund what was dysfunctional, rather than efficiently run, in an attempt to provide quick-fix political solutions. Money was thrown at problems for political reasons. Professor Drumm has suggested that that will have to stop. He holds firm views on what needs to be done and his group of experts is certain to ruffle feathers within the Department of Health, the HSE and the various medical establishments. Unless that happens, he will not be doing his job. Inevitably, reform will be resisted. Vested interests have become so powerful within a health system that has been poorly managed - largely at the whim of politicians - that they have lost sight of the duty they owe to the taxpayers who fund the services.
Value for money is something politicians demand on a regular basis. So it was refreshing to hear the new chief executive of the HSE talk about the responsibility of individuals. Everybody within the health service has a responsibility to make the system work, he said. They had to ensure that public money was spent wisely and productively. There was no point in blaming others for administrative or medical failures; everybody must take responsibility.
Reforming the health service is a very tall order. Professor Drumm has given himself five years in which to bring about radical change. He will need the support and goodwill of practitioners within the system. New structures are required. And old, inefficient work practices and areas of demarcation have to be addressed.
Since taking over at the Department of Health last September the Tánaiste, Mary Harney, has been under pressure, responding to a succession of scandals affecting old people in nursing homes; her failure to deliver on doctor-only medical cards; disputes with consultants over insurance cover and threatened industrial actions by doctors and nurses. It has been a torrid and disheartening time. It is to be hoped that Professor Drumm can change all of that, acting independently of the Government and the vested interests.