Michael Harty (Clare, Independent) | Oireachtas source

The Grace case illustrates a lack of proper governance, accountability and transparency within the HSE. It amply illustrates the dysfunctionality that exists in the HSE. Some 15 months ago, the CEO of the HSE said that it is an amorphous mass that nobody understands, that it lacks vision and a long-term plan. When Dr. Aidan Halligan was offered the post of CEO of the HSE in 2004, he looked at the executive and described it as being over-managed and under-led. HSE management has lost the trust and respect of the general public, which depends on it to provide good governance and good leadership. There are many examples of dysfunctionality within the HSE, the Grace case being the most recent. There is a litany of mismanagement within the HSE. I refer, for example, to the hospital waiting lists and trolley queues. Our children's hospital has been delayed for ten years as a result of flip-flopping on the location, consultancy fees and delays in planning. There is also now a huge premium to be paid for building the hospital on a brownfield site. There has been failure to build capacity in our health services, failure to create a satisfactory work environment for our medical graduates who are emigrating and a failure to develop proper primary care services. This is all down to poor governance structures in the HSE, which lack a clear vision and an integrated, innovative planning process.

The Grace case illustrates what happens in the HSE when a problem is found. First, there is a failure to recognise that a problem exists even though it is readily identifiable. The HSE continues to compound the error when it has been identified. It denies that the problem exists even when whistleblowers have uncovered the shortcomings. It sets up commissions of inquiry - and in this case two commissions of inquiry - and then delays the publication for several years on the grounds of due process and legal constraints. It took three years to report this matter to the Garda. Even then, it was only when the HSE had no choice. Only when evidence becomes overwhelming will the HSE respond and issue an apology, which is often too little and, as in this case, too late. The HSE has lost touch with the people it serves.

See this speech in context