The Government now finds itself having to secure a person to run the health service on a day-to-day basis and someone to implement the ambitious Sláintecare reform programme.
Following the announcement by Tony O'Brien that he would be stepping down as HSE director general when his contract expires next summer, the Public Appointment Service is expected to put in place an open competition for the role.
The post attracts a salary of about €186,000, similar to the pay rate for the Garda Commissioner. However, the Government has signalled it will consider increasing the remuneration to between €200,000 and €250,000 as well as potentially introducing an accommodation allowance to attract an appropriate candidate to run An Garda Síochána. Sources said last night it was too early to say whether an enhanced package would be offered for the new head of the HSE.
A number of sources maintained there was frustration at political level on occasions about firm commitments being made by the HSE to the Department of Health or the Government and not being delivered
The announcement of the departure of Mr O’Brien did not come as a surprise.
It had been believed widely in political circles and among observers of the health service that Mr O’Brien was unlikely to seek another term.
Mr O'Brien had signalled to the Minister for Health Simon Harris several months ago that he was likely to step down and he confirmed this in a formal letter in recent days.
Tensions
There was general acknowledgement on Tuesday that Mr O’Brien had provided stability to the health service during the dark days of austerity and, as well as being an affable individual, he was an accomplished performer in the media who defended the HSE and the Government in a number of tricky situations.
However it is no secret that there were tensions at times during the tenures of both Leo Varadkar and Simon Harris in the Department of Health.
A number of sources maintained there was frustration at political level on occasions about firm commitments being made by the HSE to the Department of Health or the Government and not being delivered. Some in Government also viewed the regular correspondence surrounding its annual service plan as representing an obvious pitch for more money.
A headline in a major interview in the Sunday Business Post in late 2015 which said “HSE chief – no plan, no money, no vision for health” also raised eyebrows among politicians.
Friends of the HSE chief point out he had been arguing for years about the need for a cross-party agreement on the future direction for the health service and for major capital and revenue investment to support such an initiative.
Ironically, this has now come about in the form of the Sláintecare reform plan backed by all parties in the Oireachtas and the recent Government announcement of a €10 billion capital investment.