The Health Service Executive (HSE) was "at war" last year with senior politicians, the Department of Health, trade unions and many other stakeholders, its chief executive has said.
Paul Reid told the Industrial Relations News conference that when he took up his role last year relations were strained with the then taoiseach Leo Varadkar, the then minister for health Simon Harris and others.
However, the situation had improved considerably since and a major increase in funding had been secured from Government for the year ahead.
Mr Reid said he was not speaking lightly when he said his experience was that at the time the HSE was “at war with most of its stakeholders”. He also said the HSE did not have a strong relationship with the wider public.
He said the view of the government at the time was that a lot of money was going into the health service and it did not know what financial positon it would be in at the end of last year.
Getting a grip
His early challenges, he said, included getting a grip on the HSE’s finances and stabilising its relationships with key stakeholders.
“It is OK to be at war with some of your stakeholders some of the time but all of them all of the time is not good for anybody.”
Mr Reid he also believed that the HSE had to listen and take cognisance of voices in the health service as there was a “strong disconnect” between the parties.
“We had become too much of an administrative system at the centre of the HSE.”
Mr Reid said that since the Covid-19 pandemic hit, he had never experienced so much change in so short a period of time. He said the HSE and the health system in general had built up stronger confidence and trust with its stakeholders, including the Government which provided an additional €4 billion in the budget earlier this moth.
The HSE had, he said, had a damaged reputation over many years and he urged industrial relations practitioners to represent their interests and members in a way that did not involve slamming or damning it. He said that when the public heard very fractious or very damaging comments, confidence was lost in the system.
Fragile economy
Mr Reid said the country’s economy was very fragile and that expectations on the industrial relations front needed to be managed carefully given the financial hit experienced during the pandemic.
He said resolving a pay parity issue would help the HSE in recruiting hospital consultants and that more were taking up roles. He said there had been a net increase of 155 consultants in the public hospital system this year but he wanted to recruit more.
The removal of the additional unpaid working hours for staff - which were put in place under the 2013 Haddington road agreement and which unions now want to end - would have a “significant and major impact on the HSE”and other public bodies as rosters and clinical care had been built around these additional hours, he said.
Mr Reid, a senior official in the Department of Public Expenditure when that agreement was being put in place, said the view then was that these measures were not temporary but rather part of a “sustainable model to improve efficiency in the public service”.
