We need professional management

Every part of the Irish health service must be managed at a professional level by people with knowledge, understanding and the necessary skills, Health Minister, Dr. James Reilly told the HMI Annual Conference.

Dr. James Reilly, T.D.
Dr. James Reilly, T.D.

“We need health managers with high levels of skills who are constantly improving themselves.”

Underlining the importance of good management, the Minister said figures provided by Dr. Susan Reilly of the National Cancer Control Programme showed that with improved organisation alone there was a 10 per cent improvement in services.  There was little point in having excellent clinicians if services were not organised in a way that helped them to deliver to the best level.

Recalling how before he became President, Bill Clinton had a sign on the wall saying “It’s the economy, stupid,” he said health service managers should have a note saying “It’s the patient, stupid.”

“It’s dangerously easy to follow process.  I want to turn process upside down to see that the patient comes first, second and last.

“We grapple with the challenges of delivering complex services.  Historically, the first instruction to doctors as been ‘Do no harm’.  As a GP, I have woken up in the middle of the night wondering if I had got it right with that last patient.  That is where we all start – with the determination that every patient comes out in better shape than they were going in.  But there have been headlines in recent years where patients have been harmed by the health service.”

It’s dangerously easy to follow process.  I want to turn process upside down to see that the patient comes first, second and last.

The Minister said health care must be delivered at the lowest level of complexity.

Emphasising the need for accurate and real time information, he said we had to capture information and use it in a better way and that is one of the great achievements of the new Special Delivery Unit.  “I was told that to get the information we needed on waiting times would cost €10 million and take 18 months.  Dr. Martin Connor, Head of the SDU, with the help of excellent people in the HSE and the NTPF, has done it in 18 weeks for €250,000.

“We need the same visibility and knowledge right across the financial systems. If a hospital is going off budget, we need to know it within days of its happening and not months later.

“The SDU will build on the HSE clinical programmes and initiative already under way.  Demand for services is now greater than ever before and we have less and less money to fund these services.  But we have the structure and reform plans and the people (many of them in this room) and we can make the changes necessary to deliver the quality of care our citizens deserve.  Together we can do this and I hope today is stimulating and productive and you all learn from today’s events.”