New chairman of the Health Service Executive Ciarán Devane has warned the health service has to stop "surprising" the Government with massive overspends and suggested charities could play a bigger role in fighting cancer, mental health and diabetes.
In his first appearance before an Oireachtas committee, the Dublin-born Irish speaker was asked if he was full time as head of the new HSE board.
“No. I’m juggling at the moment,” he said.
Mr Devane, who was appointed last September, is chief executive of the British Council, the UK’s international cultural and education organisation, which operates in more than 100 countries.
“What I have said is that we are having a new chair arrive into my current organisation [the British Council],” said Mr Devane.
“I was staying beyond Brexit but of course we don’t quite know when Brexit is going to be or if Brexit is going to be.”
Mr Devane added that his HSE role was “non-executive part time” and that “the expectation is two days a week [work] in my case”.
A former member of the board of National Health Service in England, he said he believed that was enough time to effectively govern the HSE.
“I am not the chief executive. I have to hold the chief executive to account. There has to be sufficient time in that – you have my commitment to making sure there is sufficient time for that,” he added.
Mr Devane said he was also satisfied he had the power to remove senior managers in the HSE, up to the newly appointed director general Paul Reid, if he felt it necessary.
“If we felt that the performance of the organisation and the health of the population was at risk because of the performance of any individual then absolutely, as a board, we would be doing that,” he said.
Outlining his plans for the HSE, the former head of UK health charity Macmillan Cancer Support suggested charities in Ireland could play a much more prominent role in cancer care, mental health and diabetes prevention.
There was “some very good work” done in the UK in “mobilising” mental health charities, in particular, to work in “collaboration with the health service”, he told TDs and senators on the health committee.
A lot of health issues could be prevented if there was earlier intervention, he suggested, which would mean less pressure on front line staff in the future.
“I have no reason to believe that wouldn’t be true here as well,” he said.
Is charity the answer?
Mr Devane agreed Ireland is lagging behind other developed countries in its mental health staffing levels and resources, but said charities “can set the tone and expectation.”
“I think the collaboration between the HSE and the system more broadly and the voluntary sector and the charitable sector, I think there is a lot that can be done there to make sure that there are coherent strategies, in mental health, cancer or diabetes,” he added. “One of the things I would be looking for is a mechanism to do that.”
Mr Devane said he was committed to implementing Sláintecare, the Government’s 10-year plan for the health service. But he warned that the HSE needs to “respect the budget” handed to it by the government.
“We can not spend money that is not allocated by the government, by the Oireachtas. We shouldn’t be doing that,” he said.
The HSE needs the “financial grip” to not “surprise” the Government with its overspends, he told the committee.
“The experience of last year is that we shouldn’t be in a position of coming up with a supplementary [budget] where the gap is bigger than you would see in some jurisdictions with much larger budgets and much larger populations – not just the percentage gap but the absolute gap,” he said.
“So I think we have a job to do. And we have to do it in a way that doesn’t damage the fundamental interests of the patient or service user.”