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‘HSE needs a board of management’ – IHCA Secretary General

The lack of a HSE board was highlighted by a number of speakers (though the HSE does have a directorate that holds monthly meetings).

IHCA Secretary General Mr Martin Varley told journalists that he thinks the HSE should have a board. The lack of a board in the leadership of the Executive was also raised by Prof Brendan Kelly, Consultant in Psychiatry, Tallaght Hospital, Dublin; and former Master of the Rotunda Hospital Dr Sam Coulter-Smith during their talks on governance in the health sector in the afternoon session at the Conference.

The IHCA has called for a larger clinical role in governance in more Irish hospitals.

Minister for Health Simon Harris told journalists at the Conference that he thinks it is “very important  that the voice of the clinician is heard in the health service”.

IHCA President Dr Tom Ryan said during his speech that there “is little or no clinical governance in Irish healthcare”.

“Except, that is, in voluntary hospitals such as the three Dublin maternity hospitals that provide excellent care on a shoestring budget. These voluntary maternity hospitals are an excellent example of how good clinical governance works in practice in Ireland.”

Dr Coulter-Smith expressed some concerns over the impact of the new Hospital Group structure on voluntary hospitals.

“So there are some obvious problems in the system. The changes have been ill-thought-out and rushed. There are far too many unanswered questions,” he argued.

“Existing structures in the voluntary sector are being put at risk. Questions regarding the legal status and ownership of voluntary hospitals and the future of their boards have not been decided, and I think this is a real problem. Under this system, my fear is that the voluntary sector will be run into the ground.”

Speaking in a questions and answers session later in the day, Dr Coulter-Smith was asked what changes should be made generally in hospital governance.

“I think we can start at the bottom or the top,” he said.

“At the moment, we have services that rely far too heavily on locums and we have poor reporting systems in many of our hospitals; we have to have permanent staff that are able to report upwards.

“At the moment, there are far too many blocks in the system. The system relies far too heavily on financial rather than clinical reporting. So I think we have to tidy-up the system and allow clinicians to have seat at the management table and to be able to report appropriately on issues.”

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