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Some ‘command-and-control’ approaches ‘creeping back’

By Paul Mulholland - 09th Jul 2023


A recent partnership document aimed at improving the relationship between voluntary organisations and the State notes the return of some “command-and-control” management approaches in the post-pandemic period.

Partnership Principles: Building a new relationship between voluntary organisations and the State in the health and social care sectors was published in April.

The document arose from discussions with voluntary organisations in the Health Dialogue Forum (HDF).

The HDF was established by the Minister for Health to provide a platform for regular dialogue between the State and voluntary providers. The impetus for its establishment was the final report in 2019 of the independent review group charged with examining the area. 

According to the new partnership document, State and voluntary organisations need to change their behaviours and relationships to embed partnership principles into their structures, processes, and projects.

“This will not be easy as changing relationships, behaviours, and attitudes is complex, contentious, and messy,” according to the document.

“In fact, there are already some limited examples of command-and-control type approaches creeping back as the unifying threat of Covid-19 wanes.”

The principles outlined in the document are: Accountable autonomy; collective leadership; ‘problem-solving deliberation’; innovation and learning; transparency; engagement and participation; trust and mutual respect; and quality people-centred services.

It also calls for the principles outlined to be “embedded in practical action”.

The CEO of Tallaght University Hospital (TUH) told the Medical Independent (MI) that the document offers a strong basis for future relationships between voluntary organisations and the State.

Ms Lucy Nugent commented: “The partnership principles were only launched in April. So it’s early days in that new relationship. But I think everyone has welcomed it as there is nothing in it that anybody would disagree with. Really, it’s more about us living out those principles.”

At a TUH board meeting in April, it was noted that no press release was issued in tandem with the document’s publication.

The Voluntary Healthcare Forum, which represents voluntary organisations, intended to “engage in social media and issue a press statement regarding the launch of the partnership principles”, outlined the minutes.

At this meeting, the board was due to discuss and approve the new service level agreement (SLA) with the HSE. However, the SLA was not received on schedule.

“Board members raised concerns regarding the delay in receiving the SLA and suggested escalating the board’s disappointment at same.”

At the time of going to press, MI was informed the SLA had still not been received.

More broadly, a working group is in place to examine revised SLA arrangements between the HSE and voluntary agencies. See news interview.

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