Covid-19 might not have gone away, but the post-pandemic flow of people from the health service is turning into a flood.
The latest departure, that of deputy chief medical officer Ronan Glynn, who announced on Tuesday he is to step down, means the Department of Health's coronavirus response will lack an experienced and battle-hardened figure to plan for the next wave of cases, likely to arrive this autumn.
Dr Glynn leaves at the end of this month, while his boss, State chief medical officer (CMO) Tony Holohan, departs a month later.
As there are a number of deputy chief medical officers in the department, the number two position can be filled easily enough. Finding a replacement for Dr Holohan following the botched attempt to move him to an academic position in Trinity College will take longer.
Ironically, Dr Glynn would have been a strong favourite to become the next CMO given his starring role during the pandemic.
Though relatively inexperienced, and occasionally prone to mis-speaking during the height of the pandemic, he demonstrated effective gifts for clear communication and amply filled Dr Holohan’s boots when the latter was on leave in 2020.
In his new job with consultants EY, he can expect to earn a multiple of his present principal officer grade salary at the department of about €120,000 a year.
EY earned almost €20 million in fees from the Health Service Executive during the pandemic; one of its leading executives, Niamh O’Beirne, became national lead for the testing and tracing programme.
The ongoing massive increase in spending on health and last year’s cyberattack on the HSE is proving a bonanza for consultants and the private health sector generally. The irony now is that these bodies are poaching senior health figures to carry out this work.
According to the Standard in Public Office (Sipo) commission, civil servants in certain “designated positions” – from principal officer grade up – have to get approval from their secretary general where they are moving to a post outside the civil service within 12 months of resigning.
Salaries at the top
Sipo provisions do not apply to the HSE, where chief operating officer Anne O’Connor is moving to head up the health and wellness division of the VHI.
Salaries at the very top of the health service are strangely uneven, even among staff who soldiered together during the pandemic; department secretary general Robert Watt earns €294,000, HSE chief executive Paul Reid earns €420,000 while Dr Holohan was on €187,000.
Money only partly explains the growing exodus from the health service, however. Many other staff are leaving because they are tired after two years of exhausting firefighting in frontline medicine.
Prominent doctors who have done the State much service, such as obstetrician Chris Fitzpatrick and intensive care specialist Catherine Motherway, are leaving public practice early.
Other staff are leaving because of the continuing disorganisation in health, and the long hours and organisational stasis this produces. Some experienced personnel delayed their retirement because of the pandemic and are leaving now.
This is the brain drain that really matters in health, one whose effects are felt in hospitals and the community every day.
