Oireachtas Joint and Select Committees

Wednesday, 3 July 2019

Joint Oireachtas Committee on Health

Health Service Executive: Chairman

Mr. Ciarán Devane:

I believe we have a role in determining strategy, in collaboration with others. We operate in an ecosystem. The policy side of strategy, which is the purview of the Department, informs how we do what do. That needs to be a dialogue, and there are choices to be made in finding the best way to implement an agreed overarching vision and strategy. If strategy is about making choices about what to do when, what to do later, and what not to do at all, then we absolutely have to have a role in that. However, I do not believe we should do that in isolation. It is a public sector board, so we do it in the context of overall policy, and we have to ensure we work with the other organisations in the ecosystem as well. We should not be isolationist or do things on our own. We have to engage in that dialogue. If we believe that good dialogue leads to good strategy, then that is important.

In terms of accountability, as well as having the carrot and the stick, it is important to have the right processes in place, because they create clarity so people know what they are being held accountable for, and that that accountability is for the whole range of things. One person is not accountable for the money and someone else for meeting the access targets. It has to be collective because they are so intertwined. I see it as making sure that cascade of accountability, and the necessary clarity, are in place. We also need to recognise and reward where people are performing. The reward does not have to be financial, but can be about opportunity, engagement, promotion, and so on. Equally, if someone is not performing, we need to have a conversation with them, and they might be better off elsewhere.

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