Managers leaving the public sector

Serious concerns are arising regarding the public sector’s ability to recruit and retain top class managers, writes Maureen Browne.

Maureen Browne
Maureen Browne

The shock departure of HSE Deputy Director General, Laverne McGuinness from one of the most prestigious jobs in the public health sector for the private sector has crystallised concerns about the difficulties in recruiting and retaining high calibre managers in the public sector.  She left to take up a role with the Talbot Group.

With Director General, Tony O’Brien,  Ms McGuinness had been the public face of the HSE, regularly representing the Executive at Oireachtas Committees and well known to staff having  worked in the public health services for over 19 years.

She had been with the HSE since its establishment over ten years ago and been Deputy Director General since January 2013.  From October 2009 to December 2012, she was HSE National Director of Integrated Services and was previously HSE National Director of Primary Community & Continuing Care. Before the establishment of the HSE she worked as an accountant and Asst. Chief Executive with the former Northern Area Health Board.

This month it was revealed that another senior health manager, Ms. Margaret Swords who was Deputy Chief Executive and Chief Operations Officer at the RCSI Hospitals Group and previously worked as General Manager at the Louth Meath Hospitals Group and Deputy CEO and Head of Operations at Beaumont Hospital  was leaving  to become Chief Executive at Aut Even Private Hospital in Kilkenny.

Chief Executives of the acute hospital groups appointed in October 2014 are now well into their two year tenure of office and will require to be re-appointed or replaced this Autumn.

The departures of Ms. McGuinness and Ms. Swords follow those of a number of other leading healthcare managers in recent months.

Mr. Bill Maher left his position as Chief Executive of the RCSI Hospitals Group late last year to take up a post as Chief Executive of the Bon Secours Health System.  Mr. Maher had previously worked as Chief Executive of the Saolta Hospitals Group and before that as Chief Operations Officer at St. Vincent’s University Hospital, Dublin.

Ms. Sarah Brady McMickan left her post as Deputy CEO of Tallaght Hospital, Dublin to take up a post as Group CEO of the Beechfield Care Group.

Last year Dr. Tony O’Connell, then HSE National Director of Acute Hospitals resigned from his post after less than nine months to return to Australia.   He said one of the reasons for his departure was the  “much-reduced” salary he received in Ireland compared with Australia was too much of a financial challenge for him.

The importance of providing attractive salaries for health managers was acknowledged by the Minister for Health himself at the Autumn 2015 Conference of the Irish Hospital Consultants Association.

And while not leaving the public for the private health sector another senior health manager moved out of the health area when Ms. Ann Doherty left her post as Chief Executive of the University of Limerick Hospitals Group to take up a post as Cork City Council Chief Executive.

The HSE is now facing a number of few recruitment challenges.  A spokesperson said the post of  Deputy Director General  will be advertised shortly.

In the meantime, the Chief Executives of the acute hospital groups appointed in October 2014 are now well into their two year tenure of office and will require to be re-appointed or replaced this Autumn.

The difficulties in recruiting and retaining CEOs and indeed senior managers have been exacerbated by the reduced salaries implemented by the Department of Health for CEOs of Acute Hospitals and for the CEOs of Social Care Organisations.

Since September 2015, there are two  groupings for new appointments for the salaries of CEOs of Section 38 agencies. The salaries for hospital CEOs now ranges from €64,812 to €121,600 (5 distinct bands of Hospital), while the salary band for social care organisation CEOs now ranges from €64,812 to €110, 000 (4 distinct bands).

Managers are finding it very difficult to understand how the Department saw fit to reduce salaries at a time when managers’ work has become far more difficult and they are frequently being held publicly responsible for shortcomings in services for which they cannot find resources.

The importance of providing attractive salaries for health managers was acknowledged by the Minister for Health himself at the Autumn 2015 Conference of the Irish Hospital Consultants Association. He said that while it was not popular to suggest increased salaries for managers, it was important that we attracted the right calibre to these posts.

Some managers are quite bitter about the current situation.   “Fair play to those who are leaving,” said one very disillusioned manager.  “I would leave myself if I could.   All I get from this job is stress and public odium.  I am told to manage, but I don’t have the money to manage properly and to provide the comprehensive services required.  I can’t recruit the staff I need.  I am constantly concerned about the plight of patients who can’t get to an outpatient clinic or be admitted, my staff are under ridiculous pressures and I am pilloried in public.   There are times when I feel just like a punch bag for all sides.”

A colleague was in broad agreement saying “I appreciate I have a permanent job and in the recent difficult times I have been grateful for that.  However, I have got to the stage where I dread going to work – I am continually fire-fighting and trying to solve seemingly insoluble problems.  I have no time to plan ahead and to try and introduce new thinking and initiatives.  It is becoming increasingly difficult to remain positive and to provide positive leadership.  It is also a bit disheartening to listen to ads from the private health sector, where resources do not appear to be as tight as they are with us.”