Oireachtas Joint and Select Committees

Wednesday, 19 October 2016

Select Committee on the Future of Healthcare

The Cancer Strategy as a Case Study of Health Service Reform: Professor Tom Keane

9:00 am

Photo of James BrowneJames Browne (Wexford, Fianna Fail) | Oireachtas source

In thinking about the health system in Ireland I am reminded of the old yarn about the Kerry man who said, when asked by an American tourist for directions, "I wouldn't start from here". That is part of the problem. As my party colleague Deputy Billy Kelleher politely said, we have a complex health system. It is effectively dysfunctional but that is no reflection on the people working in it. Most of the people working in our health service are pulling their hair out with frustration at its dysfunctional nature. The nature of the dysfunction is part of the difficulty because we have silos, fiefdoms, localism and a lot of vested interests. Everybody can see that we need change and there seems to be relatively broad agreement on where we need to get to but nobody sees him or herself as the problem or even as part of the problem.

I am interested in the issue of change management. We met an IT specialist a couple of weeks ago and discussed the introduction of a new technology system for consultants. The consultants bought into that but the IT guys were given zero funding to effectively bring the consultants along, to train them up and explain why the system should be used. To bring about change in the health system we need buy in from the public and the trade unions. When we get that buy in from the trade unions, we need to bring the staff along with us to effectively implement that change. I am reminded of the scenario, for example, with cancer where we had the very political situation where people did not want to lose their local cancer units. A similar scenario arose with regard to mental health. The policy document, A Vision for Change, had broad support from the politicians, medical personnel and patients. Leaving aside the lack of full implementation, even the suggestion of the closure of certain units did not get public buy in. There was a trust issue at play there as well. I ask the professor to outline his views on and his experience of bringing both the staff and the public along in the context of change management.

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