The new chief executive of the Health Service Executive (HSE) said today he would reward performance and simplify the hospital system as part of his plan for his five-year term.
Prof Brendan Drumm
Prof Brendan Drumm is responsible for the health service's €11 billion annual budget and almost 100,000 staff.
Speaking at a media briefing at Cherry Orchard hospital this morning, Prof Drumm said too much money was thrown at services when they fell apart and not enough was given to reward excellent performance.
"We do not have a system of rewarding people who are working excellently. You can work very hard at building something and because it does work no one offers you anything to continue," he said.
"I want to measure what people are doing. Not to check up on them but to measure and reward high performance. Without that people become demoralised."
In his first newsletter to HSE staff yesterday, Prof Drumm said one of his main priorities was to simplify the health service to make it easier for people to access it.
"For example, at the moment if patients need a number of different clinical or paramedical services, they must navigate through the system and pass from discipline to discipline.
"But because it is so complex, the system can fail and patients can slip between the cracks." He criticised the hospital system as being extraordinarily hierarchical and said team-working was crucial in simplifying access to the system.
Prof Drumm said improving community-based health services is key to solving the crisis in A&E care.
"We need to revolutionise community services. We need to focus on creating teams of social workers, GPs, public health nurses and pscyhologists working in the community," he told reporters this morning.
He also stressed the importance of developing an approach to caring for the elderly in Ireland.
"What I'm saying to political parties is that we have a responsibility to come up with a policy to care for the elderly and they need to drive it," he said.
He added: "Whether we create nursing home beds that people pay for themselves or use taxpayers' money - this problem is not going away. Our population is ageing and we need to place people appropriately."
Prof Drumm said he was totally committed to the development of nursing, saying it was the "engine" that drove the health service. He said he wanted to see an increase in the number of Clinical Nurse Specialists in many areas.
Prof Drumm said he did not expect improvements to happen overnight but could not be left for another 10-15 years.
In the newsletter, Prof Drumm indicated the public also need to be educated about the high quality of care available at GP level. "We need to steer people away from thinking that if they don't get treated in a hospital they won't get proper care," he said.
Minister for Health Mary Harney promised to tackle A&E overcrowding with a €70 million plan almost a year ago.