The burning HR issues in the Irish health services

In response to the interest in his article in our last edition, Health Service Manager ‘Laurence Nightingale’ responds to some of the letters he received from change-weary leaders in the public health system.

Dear Laurence,

In correspondence with my HR department recently, I was asked to identify two posts for ‘suppression’ in order to fill a vacant post. Is this correct?

Worried, Galway.


Dear Worried,

Yes it is. The capacity to ‘suppress’ or smother staff was identified as a key element of the new competency framework for future health service leaders. It forms an essential part of an overall management ‘tool-kit’ which includes expertise in areas such as ‘control’ and is modelled on a similar handbook used in the Russian Politburo in the early 80’s.

Yours, L.N


Dear Sir,

I was approached by a member of staff recently seeking my permission to release him from his current contract in the event that he successfully negotiates an ‘Expression of Interest’ meeting. Hitherto, he has only expressed an interest in leaving the office at 4pm. Can you shed some light on this please?

Confused, Dublin


Dear Confused,

In the dark old days of the Celtic Tiger, staff retention was a massive problem. Health service employees were a portable bunch with sought after skills that were much in demand. Thankfully the recession has ensured that, for the most part, staff are now shackled to their employers in perpetuity.  Unfortunately there is a still a way out for some. However, in order to avail of a career advancement opportunity, you must first prove to your current line manager that you are surplus to requirement where you are and can be released to your new post without needing to be replaced. You must secure your Boss’s imprimatur for this in advance. The beauty of the arrangement lies in the fact that, if you fail to have a successful meeting with your future employer, you can continue to work at your old redundant job that wasn’t needed in the first place. This is why health service organisations are referred to as ‘Employers of Choice’.

Yours, L.N.


Dear Laurence,

I received an urgent request from a Senior Manager this week to put together a ‘robust’ cost containment plan for my hospital? I’m not really sure what this means and when I sought clarification, the line went dead…. Can you help?

Clueless, 48, Midlands.


Dear Clueless,

Fear not – this request is issued about 20 times per year. You will likely have submitted a number of iterations of this plan before but it will have been rejected on the grounds of being ‘too fluffy’.  In reality, this means that the political system is not willing to wear the consequences of said plan.

The ideal cost containment plan is one which can deliver massive savings through the culling of administrators and the purchase of cheaper toilet rolls. It needs to be both specific and vague. The specificity should focus on crowd-pleasers like ‘Cessation of Travel & Subsistence’ or ‘Back-Office Obliteration’.

Those elements most likely to cause discomfort for politicians should be communicated in a circumspect manner. Be warned however – don’t take the vagueness too far. You should try to avoid using ‘Miscellaneous – €5m’ or ‘Generation of Efficiencies – €10m’. This is the cost-containment equivalent of giving two-fingers to the Troika.

Yours, L.N.


Dear Laurence,

Have you any advice on how to engage local politicians positively in a change programme?

Hopeful, Wexford.


Dear Hopeful,

Yes. Do Nothing.

Yours, L.N.


Dear Mr. Nightingale,

Morale is very low amongst staff in my service. I’ve tried my best to keep spirits up but I am struggling. Have you any advice on how to keep employees engaged?

Desperate, North-West


Dear Desperate,

There is a myriad of management handbooks which describe the productivity gains that organisations can make if they successfully engage their employees. Most of these are written by blue-chip Svengalis who have converted their staff into high-performing ‘company men’ through a combination of rigorous performance management and free-drinks receptions. Unfortunately neither of these levers is available to you.

Consider the following however – why not invite your staff to a drinks reception where they must pay for themselves? The ensuing resentment of your parsimony will create an indelible bond amongst the foot-soldiers and, in the process, will marshal a fractured bunch of individuals into a strong and unified team – albeit with a common enemy.

Yours L.N.