Serious frictions have arisen between Minister for Health Simon Harris and the Health Service Executive (HSE) in the fallout from the controversy over waiting lists.
Health management are "fuming" over the Minister's response to Monday's RTÉ documentary on waiting lists, in particular his attribution of primary responsibility to the HSE.
One source said officials who took part in the subsequent televised debate on the programme felt they had been “thrown under the bus” by the Minister.
In an interview with RTÉ's Claire Byrne, Mr Harris said the problem of long waiting lists was "about the HSE – they are in charge of operations". In relation to the long waiting lists in Cork University Maternity Hospital he said "it comes back to management decisions".
He also repeated his view that managers who under-perform could be removed though he added his preference was that it this shouldn’t be necessary.
Slow pace
For their part, Mr Harris and his team are said to be frustrated at the slow pace of change in the health service and what they believe is resistance to their reform proposals. The Minister was particularly exasperated in recent months that a halving of the number of delayed discharges in hospital failed to lead to a significant reduction in trolley numbers.
On Tuesday night Mr Harris outlined a series of measure to address the issues raised in the documentary, including the provision of additional theatre capacity to treat scoliosis patients in Crumlin children's hospital. The opening of a new theatre there has been delayed by staff shortages.
It will carry out 194 spinal operations, significantly more than last year, according to the Minister.
He said an orthopaedic post in the hospital would be filled by June and an action plan for scoliosis will be prepared by the HSE by the end of this month.
At the Minister's request, the National Treatment Purchase Fund will audit the practice of each of the hospitals highlighted in individual patient cases featuring in the documentary and will report to Mr Harris.
Funding announced
Some 2,000 daycase procedures are planned this year with €5 million in funding announced in the Budget. These are due to get under way in March.
Mr Harris, who met with the heads of the HSE, the National Treatment Purchase Fund and Crumlin hospital during the day, has told the HSE to present an action plan on waiting lists by the end of February.
The plan will aim to ensure that no patient is waiting longer than 15 months for inpatient treatment by the end of October.
Labour has called for a full investigation of how different waiting lists were established while Fianna Fáil claimed there were management issues in the HSE but the lack of capacity in the hospital system was the real problem.