Resignations cast shadow over Sláintecare health service reforms

Government insists it is more committed than ever to implementing programme

Laura Magahy, executive director of the Sláintecare programme office,  was the public face of the Sláintecare reform plan.  Photograph: Nick Bradshaw
Laura Magahy, executive director of the Sláintecare programme office, was the public face of the Sláintecare reform plan. Photograph: Nick Bradshaw

The Department of Health on Wednesday insisted that the Government was more committed than ever to delivering the radical reforms for the health service set out in the Sláintecare plan originally drawn up by an all-party Oireachtas committee in 2017.

The Department of Health said that over the last three years “significant progress has been made in delivering this vision”.

However, the resignation of both the executive director of the Sláintecare programme Laura Magahy and the chairman of the Sláintecare Implementation Advisory Committee (SIAC) Prof Tom Keane certainly cast shadows over the project.

Keane’s letter of resignation will undoubtedly now be seized upon by members of the Opposition.

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The Minister for Health, Stephen Donnelly, is likely to be pressed as to why Keane – the man who oversaw major reforms to the country's cancer service several years ago – now believes that the "requirements for implementing this unprecedented [Sláintecare] programme for change are seriously lacking".

The Department of Health said the last three years had seen the introduction of a new GP contract, the re-establishment of the HSE board, “and an agreed unprecedented investment of €1.235 billion in Budget 2021 for specific Sláintecare initiatives”.

‘Enhanced care’

“This funding is increasing acute and community bed capacity, providing enhanced care in the community, including access to diagnostics, additional home supports, streamlining care pathways, and tackling waiting lists.”

However, while to the public at least Keane was a background figure in recent years, Magahy was the public face of the Sláintecare reform plan.

She was appointed by the then government in July 2018 as the executive director of the Sláintecare programme office with a background of working on major developments.

Magahy is a former director of Temple Bar Properties and former project manager of the Irish Film Institute. She also led the project to relocate Temple Street children's hospital to the Mater hospital site.

After leaving Temple Bar in 2000, she won a lucrative contract to provide executive services for the ill-fated "Bertie Bowl" – named after former taoiseach Bertie Ahern – and Sports Campus Ireland at Abbotstown.

Her departure from the Sláintecare programme comes at a very critical time for one of its key elements, the introduction of a new contract for hospital consultants under which they would treat only public patients.

Initial talks on this plan commenced with medical representative bodies last May, with Magahy leading out for the Department of Health. This process did not go well and there were major objections from doctors to aspects of a draft contract put forward by health service management including restrictions on advocacy rights.

Senior medic

One senior medic resigned from the SIAC in late July in a letter to Magahy.

When the talks with the medical organisations resumed last week Magahy did not lead out for the Department of Health. However, some informed sources insisted last night that her resignation was not linked in any way to the consultant talks.

This week the secretary general of the Department of Health Robert Watt said the new progress report on implementing Sláintecare would show that from a total of 112 "deliverables" for the first six months of this year, 109 were either on track or being progressed.

He suggested that the Department’s Sláintecare priorities were now to implement a detailed plan on waiting lists which is to be published shortly, progress work to build new hospitals for elective (non-urgent) patients around the country and to “scale and mainstream integration innovation and implement the eHealth programme”.