Repositioning the health services
As this is my final column as President of the Institute, I read again what I have written about during the past three years. The column I wrote for the June/July 2008 issue struck me as still very relevant. In it I referred to the recently published OECD report on our public services generally and deduced from it the objectives it suggested for our health services. They were:
- ensuring the capacity of the health service to achieve its objectives;
- motivating health services employees to perform well;
- achieving a recipient centred approach to service delivery and;
- strengthening governance
The OECD report was completed just as the global recession was beginning and, not surprisingly, we have been preoccupied since with surviving the particularly severe impact the recession has had in Ireland. The recession in Ireland may be bottoming out but it is likely that health services budgets will continue to decline in the period ahead.
I am struck by the extent to which the debate on our health services is focused on the scale of the financial cuts. There is comparatively little discussion on how best to invest the €14+ billion available to our health services this year. I believe we need to focus more on what can be achieved with the sizeable funds that are still available. The results of the survey of managers conducted by the University of Limerick on behalf of the Institute, which was reported in the most recent issue of Health Manager, raise fundamental questions about the ability of our system to realise objectives of the type suggested by the OECD.
Sir Gerry Robinson has vast experience of leading and managing large, complex organisations. Much of his experience involved reorganising, re-positioning and transforming these companies. In this issue we publish a very interesting interview he did with the editor of Health Manager recently. What he has to say merits careful study and makes eminent sense as we strive to move from surviving the recession towards positioning our services to realise the type of objectives suggested in the OECD report.