The man who was set to become chief executive of the Health Service Executive (HSE) in the autumn, Prof Brendan Drumm, said yesterday his efforts to bring a team of six people with him to his new role had presented major challenges to the system.
His comments came within hours of talks with the HSE on his contract for the €400,000-a-year job breaking down.
They broke down, he said, over a failure by the negotiating team, representative of the HSE, the Department of Health and the Tánaiste, to agree to allow him return to a job equivalent of what he was now doing after his term as CEO of the HSE expired in five years.
He is currently professor of paediatrics at UCD and a consultant at Our Lady's Hospital for Sick Children in Crumlin.
"I had informed the HSE representatives in writing on the day after I was appointed or offered this post that I would need a situation where I would be returning to my present post or at least to an equivalent post.
"This has loads of precedent; masters in the maternity hospitals are appointed, and after seven years leave their posts and a new master has to be appointed and the old master has to be given a post as a consultant.
"The directors in the HSE would have been reporting to me on a contract that allows them after their five years to return to their previous post.
"Last night I was informed that the HSE would not fund my return to clinical work. This was confused with the fact that my job is half academic - paid by UCD - and half by the HSE...I asked directly, if in the event that the UCD end of it could have been negotiated by them would they fund my return to clinical work in Crumlin, and I was informed on three different occasions...that that would not happen.
"This seemed quite remarkable to me as consistently you see consultant posts created by political pressure within the system without any measure of the need for them at a work level, and I was quite taken aback that it presented the major block to this process going forward.
"I'm sure you're incredulous that this could have broken down on this issue, and so were we last night to be honest with you. That's why I say perhaps there were other issues maybe I wasn't aware of. I don't know."
Prof Drumm expressed disappointment that the negotiations had fallen apart. The HSE had gone after him for the job, rather than the other way around, and that he wasn't interested in it for the salary.
"I can assure you despite the fact that it's being portrayed as the biggest package ever given to anybody...it had little financial gain for me involved in it."
The team he wanted to take to the HSE included 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 had not been selected.
Prof Drumm admitted there were difficulties over the fact that a public procurement process would have had to be gone through to select the people he had decided he wanted already.
Furthermore, people in the system needed convincing that his team was not taking their jobs. Other managers would be too busy to drive the reforms, and this was why he wanted his own team.