How did the HSE persuade Prof Brendan Drumm to accept its job offer? Eithne Donnellan, Health Correspondent, finds out.
Just over two weeks ago, a visibly perturbed Prof Brendan Drumm called a press conference in Dublin. He had been offered the highest-paid job in the public sector, with a salary of €400,000 a year, but he couldn't take it.
People were shocked - not because he was refusing a job with such a high salary - but because it was the second time a person offered the job of chief executive of the Health Service Executive (HSE) was walking away from it.
It seemed like the job nobody wanted. Prof Drumm admitted people thought he was crazy to have initially accepted it. The consultant paediatrician at Our Lady's Hospital for Sick Children in Crumlin and professor of paediatrics at University College Dublin explained, however, that he very much wanted the job but the terms of the contract offered were unacceptable. The main stumbling block, he said, was that he wanted to be able to return to clinical practice in Crumlin at the end of his five-year term as HSE chief executive, but the negotiating team representing the HSE and Department of Health would not agree to this. Neither would the Tánaiste and Minister for Health Mary Harney, who said she could not agree to funding another job for him after he had finished this one.
Late on the night of Wednesday, June 1st, Prof Drumm was told to take or leave the contract offered him. He turned it down.
The next morning Prof Drumm invited journalists to a press conference, but before its noon start Harney told reporters at another event in Galway that she couldn't justify providing funding for a post for him in Crumlin after his HSE contract expired. Taxpayers wouldn't approve, she said.
At Prof Drumm's press conference he looked upset at the shattering of his dream of heading the HSE. He outlined his plans for reform. He couldn't understand how negotiations on his contract fell apart over what he regarded as a relatively trivial issue - after all, he was prepared to take on a poisoned chalice - and suggested there may even have been reasons the talks were allowed to collapse which he was unaware of. He spoke of people trying to "smear" him, and of the possibility that the talks he had entered into had been "set up" to fail, given that he stressed from the first day he was offered the post in April that being given a post to return to in Crumlin was a condition of him accepting.
The board of the HSE was facing into a third major recruitment campaign to find yet another person eager to be its chief executive - Prof Aidan Halligan had decided at the last minute not to take it on either. So how did it end up this week getting Prof Drumm back on side and agreeing to be CEO from August 15th next?
It seems that the day after Prof Drumm's press conference, UCD contacted the Tánaiste's office and said it could accommodate Prof Drumm returning to a professorship when his HSE contract expired. Just after the June bank holiday, Prof Drumm visited Harney. "He called me and asked to see me and I met him and again his ideas for reform greatly impressed me," she said. She encouraged the HSE to re-enter negotiations with him.
But the board of the HSE was not too enamoured about getting back into talks with a man who had already publicly discussed the difficulties he had during his contract talks. Prof Drumm had revealed there had been major resistance to him wanting to take a hand-picked team of six people with him into the HSE to drive health service reforms. He spoke about staff in the service being demoralised, about the service throwing money at problems rather than rewarding efficiency, about directors in the HSE being on contracts which allowed them, after five years, to return to their previous posts, and about consultant posts being created "by political pressure within the system without any measure of the need for them".
AS ONE SOURCE put it yesterday, "bridges had to be rebuilt" between Prof Drumm and the HSE. This took much of the week that followed the bank holiday, and, just when trust was building, the Irish Medical Times published an interview with Prof Drumm in which he was quoted as saying: "How can reform be central to the HSE if they do not want to hire people serious about reform?"
That interview was conducted immediately after his press conference almost a week earlier. But the timing of its publication made it appear as if Prof Drumm was having a further shot at the HSE.
Despite this blip, the chairman of the board of the HSE, Liam Downey, and the secretary general of the Department of Health, Michael Scanlan, remained in contact with him. Talks between the sides continued over last weekend, and Crumlin hospital also got involved, agreeing it would give Prof Drumm a number of hours' clinical practice every week after his HSE contract expired. There were questions then over who would pay him for this clinical work as, up to now, half his salary has been paid by the HSE and half by UCD.
Harney had been adamant no extra funding would be pumped into his contract terms. It was eventually agreed that Crumlin would meet the costs of his clinical sessions from its annual budget and would not get approval for a new consultant's post for him.
Sources say the remit of UCD does not extend to guaranteeing clinical sessions and this is why the intervention of Crumlin was essential. And while it was this which finally led to Prof Drumm signing a contract for the HSE's top job on Wednesday, other issues also had to be tied up in the final days of negotiations.
It is understood that the final terms of his contract include provision for a salary of €320,000, a potential annual bonus of €80,000 and a pension worth 25 per cent of his salary over five years. He will also get a company car.
THERE HAS BEEN a lot of speculation that the real reason the negotiations fell apart was because of resistance in the HSE to Prof Drumm bringing a reform team with him. But both Harney and Prof Drumm have said this part of the package had been agreed on before the talks broke down.
The people he wants in his "cabinet" are Maureen Lynott, director of the National Treatment Purchase Fund; Dr Seán McGuire, a Carlow GP with experience in setting up GP co-ops; John O'Brien, chief executive of St James's Hospital; Tommie Martin, of Comhairle na nOspidéal; Karl Anderson, a communications consultant; and a business strategist who has not been selected.
A public procurement process will have to be gone through before they can all be appointed, but €1 million a year has been set aside to be spent on them.
The idea is they will assist Prof Drumm embark on what is a daunting task: running the health service, with its 98,000 staff and €11 billion annual budget, and implementing the most ambitious health service reform programme in the history of the State.
Prof Drumm says that "with a bit of luck" the team will help him reform services at a greater speed. But he'll need more than luck if he is to make all the changes required in the health sector during his term of office.
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