Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

5. To ask the Minister for Health the criteria for appointment to senior hospital management positions and for board appointments in each of the hospital groups; and if he will make a statement on the matter. [21105/16]

Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

My question is about the criteria for appointment to senior hospital management positions and for board appointments in each of the hospital groups. What is the process? Are all of the senior executive positions within the groups publicly advertised, with interviews? Are all board appointments in the hospital groups publicly advertised?

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

As I have stated previously, I intend to continue to implement hospital groups structures but on an administrative basis. The reason is that I asked the House to establish an Oireachtas all-party committee to develop a single long-term vision for health care over a ten year period. It is important that those discussions are progressed before I give further consideration to the issue of establishing hospital groups on a legislative basis. It would be disingenuous to move ahead with that while the committee is doing its work.

With regard to senior hospital management positions, the HSE has developed eligibility criteria for senior management posts at hospital group and individual HSE hospital level. The criteria reflect the particular experience, knowledge and qualifications required for specific posts and public sector recruitment policies apply to the filling of such posts.

Regarding the hospital group board appointments, chairs are in place for all hospital groups and board members were appointed to three out of seven hospital groups - Saolta university health care group, UL hospitals group and the children’s hospital group.

The terms of office of the Saolta university health care group and the UL hospitals group boards are due to expire shortly. Given the scale of the change process involved in implementing hospital groups, the hospital group boards must be populated with individuals with the expertise and competencies necessary to deliver on the strategic and change management agenda.

My Department will shortly advertise, through the Public Appointments Service process, for nominees to all of the hospital group boards, excluding the children's hospital group, and I expect to be in a position to populate all of those boards fully in the autumn, around the end of September. All of those board appointments will be carried out through the Public Appointments Service. It is important to do it that way for transparency. There is benefit in populating the boards, even on an administrative basis. There is a body of work to be done in terms of strategic planning for the hospital groups and the areas that could benefit from it. I intend to populate the boards and to use the Public Appointments Service to do it.

Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I asked the Minister about the process for appointments. He outlined eligibility criteria but he did not outline a transparent process. We are seeing a complete replication of the same management that was previously in hospitals in senior executive and chief executive management positions in the hospital groups. I will offer some examples. One CEO of a group was previously a CEO of a main hospital. They then became an executive of the HSE after which they became the chief executive officer of the group. Another was a director of nursing at a large hospital. They became the acting CEO of a hospital, then became the de factoCEO of the hospital and is now the CEO of the hospital group. Another person was deputy CEO of a hospital who then became CEO of another hospital. Guess what, a Cheann Comhairle? They are now the CEO of a hospital group. Where is the transparency around the appointments to these hospital groups? It is a very important process of reform. Apart from mentioning eligibility criteria, the Minister has not outlined how this Government or the previous Government delivered a transparent process of recruitment for the management of the hospital groups. The Minister must clarify the matter.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I am accountable to the House for the decisions I have made during my time as Minister for Health. That is what I was endeavouring to do in my initial response to the question, by outlining my philosophy and principal objective in how I intend to populate the hospital group boards which are not currently populated. I assure the House that nobody will sit on a hospital group board or be appointed by me to such a board who has not come through the public appointments system. That is important.

However, the Deputy raises a valid point relating to the appointment of senior hospital positions. The Deputy is probably aware of the history of this. There was a Government decision on 14 May 2013 on the reorganisation of public hospitals into hospital groups. Sanction of that was conveyed to the HSE in July 2013. There was an urgent request from the HSE in August 2014 to reassign senior managers from within the health service to the hospital group CEO posts. That was done on the grounds of exceptional circumstances and with the agreement of the Department of Public Expenditure and Reform. It was also done on the basis that these proposals would not result in any additional senior posts within the health service, considering the financial situation of the country. The Department also agreed that the individuals would be assigned to these posts for a period of up to 24 months in the first instance, so this issue will arise again and it will be up to me to develop policy for how we wish to move forward.

Jack Chambers (Dublin West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister mentioned exceptional circumstances but the issue is that the same chief executives have become chief executives of the groups. Their positions in the hospitals must be filled so a hospital senior executive manager has to move from another place. We are seeing a de factolocum system for managers in our health service. It is a managerial merry-go-round. It is a cosy cartel, with insiders in senior executive hospital positions rotating around. If we ran our hospitals in the same way as the managers are moving around, we would be in complete chaos. It is the equivalent of consultants or senior clinicians rotating around the different hospitals every year, so they cannot implement change management. We have a system of managers changing but no strategic change within our health service. I urge the Minister to investigate the rotation of managers within senior executive positions in the health service. It is not transparent, despite the exceptional circumstances. I do not accept the point about the eligibility criteria. I urge the Minister to deal with this matter soon.

Simon Harris (Wicklow, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I take the Deputy's point but I reiterate my point that these appointments were made for a 24-month period. We did not have a scenario whereby people were sanctioned for the rest of their career. These appointments were made initially for 24 months, considering what the then Government decided was the particular and extraordinary circumstance of trying to get these hospital groups up and running. There is a serious issue in the Irish health service, however, in terms of ensuring we can attract and retain the appropriate level of management and clinician we want. I would appreciate it if the all-party committee on the ten year plan would examine that. I am meeting hospital managers and hospital group CEOs at present and I am looking into the whites of their eyes and saying, "I need you to live within your budget" or "I need you to do this on patient safety". I need to know that we have the calibre of people that is required and I do not mean this in any disrespectful way to the people currently doing their jobs. However, the Deputy will be aware that there was difficulty in managing to find people to apply for the posts and certainly in finding anybody to agree to take up the posts. These were the circumstances in which these individuals stepped up to the plate. They are doing their best and, in many cases, are doing a good job. It is for a 24-month period, after which it will be reviewed.