Building a culture for success

One of the unfortunate things when the HSE was born was that leadership was considered a frivolous activity, Mr. Tom Lynch, Group Chair, Dublin Academic Medical Centre, Ireland East Hospitals Group, told the Conference.

Tom Lynch
Mr Tom Lynch

“If we are to succeed in providing better outcomes and utilising resources, we must develop management and leaders. Without management, without leadership, we can never achieve anything.

Mr. Lynch, who spoke on “Building A Culture For Success,” said that the seven hospital groups were to provide the impetus for hospital trusts.

The HSE was one of the most criticised organisations in the country but when you employed nearly100,000 people and delivered a multiplicity of services you were going to be in the spotlight. “My experience is that they are very committed people.”

Mr. Lynch said that he believed the statutory basis for the hospital groups was as far away as five years, which raised the whole question of governance. With the exception of the Western network, all the other networks contained voluntary and statutory hospitals.

“My whole life experience has been in the private sector which has been regularly reviewed and updated generally after a scandal and this is reflected in statute law and non statute law as best practice.

Integrity and honesty must be the foundation of all we do.

“But hospitals are not and never can be businesses and a business culture can be against the safety of patients. There is much to be done to build and develop a culture which dictates best patient outcome in the context of government resources. There was never a golden era where hospitals were run by a clinician with a Rolls Royce outside the door, a matron with a rod of iron and a secretary manager who paid the bills and looked after the books.”

Mr. Lynch said there had been a revolution in treatment of many diseases in the last 30 years, spurred by pharmaceutical innovation and a huge improvement in surgical techniques and support for patients. Now many, but not all of our hospitals were extraordinarily well built and well equipped.

“I find the job of chair of the hosptial group much more challenging than working in the private sector. In building a culture, I am trying to build a culture based on openness, transparency, accountability, engagement, integrity, honesty and leadership.

“We have an obligation to be open and transparent. It offends me grievously when I see parents of a child with cerebral palsy pushed through the courts system. Why can’t we adopt the New Zealand system? We recognise that a child born with cerebral palsy is going to be under the care of the state, so let us not put families through the court system, but develop a non legislative solution.

“We need a culture of openness and transparency throughout the health service. Patients don’t want to sue, they want to know what happened and that it will not happen again. Boards must be engaged. Integrity and honesty must be the foundation of all we do. If the aviation industry operated on the basis that health care has operated for many years, many of their ‘planes would fallout of the sky’. With no fault open disclosure we could learn lessons and do better next time.

“We must be fit for purpose. With the changing demographic profile of the Irish people, the most pressing need of all in many ways is to integrate with primary and community care, Many of the diseases of the future will be managed by primary care in the community because they will not be suitable for the hospital system. We must have a better run hospital system and we must work better with the community system.