Major changes underway in the Department of Health

Having clarified our role and priorities, we have moved into the implementation phase of a major organisational change programme that will see improvement in how we organise and operate, develop and support staff, and engage with stakeholders, writes Mr. Jim Breslin, Secretary General, Department of Health.

Jim Breslin
Mr Jim Breslin

Under the Civil Service Renewal Plan, very significant reform is taking place in how the Irish civil service operates. This is particularly so in the case of the Department of Health where a major organisational change programme – titled Working Better Together – is underway. The Working Better Together change programme follows a period of intensive staff engagement to assess the organisation and set a new direction for the future.

Commencing in the final months of last year, and in parallel with the preparation and publication of the Department’s Statement of Strategy 2015-2017, we began a process to improve the effectiveness of the Department. This included engagement with staff on role, priorities, and internal communications, how we operate as an organisation and how we support staff. Progress has been made or is underway in each of these areas.

The Department is, in comparative terms, relatively small with some 350 staff and over the past five years has seen staff numbers reduce by almost 40 per cent.

We have brought greater definition to our role and this has been agreed by Government. We have developed three-year work priorities and, again, had these agreed by Government as part of the approval of the Statement of Strategy. In February Ministers published 25 key priorities for 2015 and we are working on the achievement of these with colleagues in the HSE and the wider health sector. Having clarified our role and priorities, we have moved into the implementation phase of a major organisational change programme that will see improvement in how we organise and operate, develop and support staff, and engage with stakeholders.

We have identified four major elements to our role as shown below. Further detail is set out in the Statement of Strategy.

The Department’s Role

  • Leadership and policy direction for the health sector to improve health outcomes
  • Governance and performance oversight to ensure accountable and high quality services
  • Collaboration to achieve health priorities and contribute to wider social and economic goals
  • An organisational environment where, on an ongoing basis, high performance is achieved and the knowledge and skills of staff are developed

The agreed priorities for 2015 relate to six major reform themes:

  • Drive the Healthy Ireland agenda
  • Deliver improved patient outcomes
  • Reform operational systems to drive better outcomes
  • Implement agreed steps towards universal healthcare
  • Introduce innovative funding models
  • Modernise health facilities and ICT infrastructure.

Progress on these priorities is tracked using programme management techniques and reviewed monthly at the management team, with the HSE and with Ministers. Amongst the priorities is an ambitious leadership role in relation to population health under the Healthy Ireland banner and involving major legislative change in the areas of alcohol, tobacco, diet and health and wellbeing. A large-scale priority successfully introduced is the introduction of universal GP care for children under 6 years as part of the development of more accessible and comprehensive primary care.

The Department of Health has a very wide range of important functions. After more than a decade of organisational change in the wider health sector, we consider it important that we reflect on how we are organised and how we operate as a Department. The Department is, in comparative terms, relatively small with some 350 staff and over the past five years has seen staff numbers reduce by almost 40 per cent as a consequence of retirements, departures and transfer of functions. We continue to have many very talented and committed people working in the Department. Our goal is to provide a high performance organisational environment within which they can contribute to the health of their fellow citizens.

The Working Better Together change programme is the means by which we are seeking to achieve new, more effective ways of working. A Change Programme Steering Group and dedicated Programme Implementation Team are in place. Following on from the definition of role and identification of priorities a new, high level organisational design has been agreed. This high level organisational structure is currently being worked through to inform Department-wide reorganisation. A full transition to these new arrangements will take place over the coming months.

But real change will be less about structures and more about how work is actually performed. We are seeking to achieve a Department which is focused on priority outcomes, evidence-informed, responsible and accountable, supportive of staff, committed to learning and development, and open in sharing information relevant and collaborating with others.

Since its foundation in 1947, the Department has played a major role in working with others to bring about improvements in the nation’s health and our health services. We look forward to engaging with stakeholders as we plan and implement changes, and to increasing both the effectiveness of our collaborations and our collective contribution to the achievement of health policy goals.

We would be grateful for any feedback on our organisational change programme over the coming months and this can be emailed to workingbettertogether@health.gov.ie.