A HSE board member, who was previously Ryanair’s deputy chief executive, has criticised the slow pace at which cost cutting measures he had suggested were being adopted by the organisation.
In an email exchange with HSE chief executive Bernard Gloster released under Freedom of Information legislation Michael Cawley said there seemed to be “no urgency” in efforts to cut spending and that the Government needed to be told certain savings targets would not be met.
In January, Mr Cawley had put forward 14 ideas he believed would save cash for the health service in 2025. However, by April, he told Mr Gloster progress had been too slow and that a reduction in spending for the year – including in cutting administrative costs – was “neither achievable nor realistic”.
Mr Cawley said he appreciated the health service had made efforts to contain costs but “much more remains to be done”.
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His list of recommendations for suggested savings included technology solutions for home care, reducing the amount of spending some management could authorise, and high IT maintenance charges.
He also raised over-prescribing and excess supply of certain medications, as well as the possibility private companies could use equipment and operating theatres in public hospitals during evenings and weekends.
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Mr Cawley said eight of his 14 suggestions had not been addressed and asked for closer monitoring of savings on travel, subsistence, postage costs and training.
He said that while attending a recent audit meeting, it also became clear that initiatives from the finance department of the HSE were not going to deliver predicted savings.
“If this attitude and approach don’t change, I propose that we inform the department that we are abandoning this objective as it makes no sense to continue with the pretence that we are serious about it,” he wrote.
In response, Mr Gloster said he thought he had been clear about which of the 14 suggestions were “doable for now”.
Mr Gloster said his record of acting to address issues relating to cost stood up well against any of his predecessors but he had concerns in relation to some of the suggestions with regard to “achievability”.
He said 2025 was a “daunting” year for the health services and that some of the changes would be “slow to bite” and yield results.
“I share frustration at [the] time and pace of some change,” he said. I have told department and indeed Government at last Cabinet Committee that while pay control is established [for the] first time ever and we held ground on recent dispute, that I am concerned about non-pay.”
Not sure if that equates to abandoning the measures but again happy for [the] board to reflect a view as it is a significant issue.”
In response, Mr Cawley said that a shift in the “commitment, energy, and imagination” was needed from key members of the HSE’s senior leadership team and expressed the belief that the measures initiated up that point “will fall significantly short of the target set and what I believe is achievable”.
Asked about the records, a HSE spokeswoman said: “It is the role of board members to analyse and question the work of an executive team, and the HSE executive team welcomes this.”
