Healthy tension between politicians and managers

It was a reality, but not necessarily a bad one, that politicians and managers sometimes took different views on how something might be done and the time and resources required to do it, Minister of State, Helen McEntee T.D., said when she opened the HMI 6th Annual Conference in the RDS.

Minister Helen McEntee
Minister Helen McEntee

“A healthy tension and debate between the two perspectives can be very helpful in ensuring that the necessary debate takes place on what we all agree is most important – namely “Getting It Right,” she said.

Senior health managers from all over the country packed the one day conference which was held in The Concert Hall in the RDS in Dublin, on September 29 with the theme “GETTING IT RIGHT – Making Better Choices.”

Minister McEntee said that this year’s Conference theme (“Getting it Right”) was certainly a very interesting and apt one in that it succeeded in being both timely and timeless.

“Getting it right will always be important. However, the challenges that we now face make it all the more pressing. We need to grasp the opportunities make action more immediate. At its most basic level, ‘Getting it right’ is about an attitude to doing things. It’s a philosophy for how we should work together to achieve best outcomes for patients and the health system as a whole. It’s about respect for what we can all contribute towards achieving shared goals.

“The government is clear on its objectives. It is the building of a universal healthcare system that provides integrated care and is people centred. To that end, the government is fully committed to working with others to identify and then achieve the single tier health service that best suits the needs of our people on a sustainable basis.

The government is clear on its objectives. It is the building of a universal healthcare system that provides integrated care and is people centred.

“Realistically, to achieve that goal we must get the best value from our resources through strong corporate and clinical governance, sound resource allocation and best practice in health service management.

“Access to health services is one part of the healthcare challenge. Another part is how we actually deliver those services to patients. We need to examine how adopting new ideas and technologies can radically change the way we currently deliver health services.

“E-Health is a very good example of an opportunity and a challenge especially when we talk about delivering care in the right setting and in an integrated way. In recent years, eHealth has already begun to affect the delivery of health services. That impact will increase significantly over the next decade and beyond as we move from tele-health to mobile health and the massive health related potential of the Internet of Things. Technological innovation will facilitate a rapidly changing healthcare landscape that will truly allow us to have a patient centred healthcare system. Patients will be informed and empowered about their own health in real time though mobile devices. This will facilitate lifestyle change and early detection thereby making preventative healthcare a reality in a way that has never been possible before.”

The Minister said that experience in healthcare showed the need to be always mindful of the distance between potential and actuality and the importance of staying focussed on achieving tangible outcomes.

“It’s somewhat clichéd to talk about the need for thinking ‘outside the box’ but there is no doubt that supporting innovative ideas and creative solutions hold the key to being better at what we do. For that to happen getting it right must also mean a willingness to acknowledge mistakes when they happen because, as every good manager knows, mistakes will be made. The important thing is to admit them and learn from them. That’s easier said than done, of course, because no one is very keen on admitting mistakes. But it will be impossible for the bold and innovative decision-making culture that we need to flourish in a blame oriented environment, Perhaps, therefore, as part of embracing cultural change, we could usefully bear in mind George Bernard Shaw’s observation on mistakes ‘Success does not consist in never making mistakes, but in never making the same one a second time.’

“Getting it right also means acknowledging our successes. The truth is that we already get many things right. Much of our health service works well and some works exceptionally well. It’s not about being self-congratulatory. It’s about inspiring others to come forward with their ideas. “

In the midst of all this talk about change and innovation, there is a need not to be blown away by the clamour for change for change sake. Sometimes there can be pressure to do something –anything- just to be seen to be doing something. While that’s somewhat understandable, it’s short term at best and usually piecemeal in nature. “Getting it right, therefore, doesn’t always mean change but it does require a willingness to embrace change where it is necessary and equally importantly to hold on and value what currently does work. It means a willingness to think about what we need and come up with a vision that is both realistic and aspirational. Providing such a vision is where the political process can make the greatest contribution.”

Minister McEntee said the establishment of the Oireachtas Committee on the Future of Healthcare represented a very different approach to anything that has gone before. It reflected a new reality and equally represented a historical opportunity to achieve a sustainable political consensus on the future direction of Irish healthcare.

In the midst of all this talk about change and innovation, there is a need not to be blown away by the clamour for change for change sake.

“As Minister with responsibility for Mental Health and Older People, I am particularly interested in the work of the Committee. One of its key aims is to set out a 10-year vision and implementation plan for achieving best health outcomes and value for money by re-orienting the model of care towards primary and community care, where the majority of people’s health needs can be met locally. This is particularly important for supporting vulnerable people such as those with mental health issues or the elderly and ageing population and I look forward to the Committee’s findings, recommendations and implementation plan.

She said that if the Committee succeeded it would provide a settled framework for a changed model of healthcare. This would greatly assist health service managers in the planning process that underpinned the efficient and effective delivery of services to patients making getting it right that much easier.

She said health service management was always complex, sometimes frustrating but never dull. However, the rewards of getting it right in terms of the contribution it made to the lives of individual patients and the health system as a whole made it incredibly rewarding.