It is clear from the report that many staff at the department feel their time is misspent, writes PAUL CULLEN
“ANGOLA” WAS the word Brian Cowen so memorably found to describe the Department of Health when he was minister there in the 1990s.
The description was apt for a department given to infighting at the highest levels, civil wars between vested interests, as well as a potential for landmines that could upend the most sure-footed of politicians.
Today, the department is no longer responsible for the direct running of the health service – the HSE took over that function in 2005 – but it seems from a new report by the Department of the Taoiseach that many of the problems identified by Mr Cowen are still around.
The Department of the Taoiseach has run its rule over health and found a department under siege from the seemingly endless crises afflicting the sector. Staff are frustrated and disillusioned, morale is at rock-bottom and leadership is uneven at best, it emerges from the Organisational Review Programme (ORP) report seen by The Irish Times.
The programme launched by the Government is the latest attempt to modernise the public service by reviewing the performance of individual departments and bodies. The departments of agriculture, enterprise and employment, and transport were examined in a pilot phase in 2008, and reports were published.
The Department of Health, along with the Central Statistics Office, Property Registration Authority and the Revenue Commissioners, were reviewed last year. Reports are due to be published shortly along with follow-up plans on the recommendations.
The ORP report on the Department of Health shows that even where improvements have been made to the health service – reductions in our rates of cancer and heart disease, for example, or a rise in life expectancy above the EU average – the department has been unable to claim due credit because of its poor image and the fact that it is constantly on the back foot in dealing with criticism.
The report says the Department of Health is “in transition” as a result of the formation of the HSE and has “some way to go” to shape itself into a health ministry fit for the 21st century. But significant resource constraints in the future are likely to add to the challenges it faces.
Some observers have wondered what the department actually does now that the HSE is operating the health service. The departments annual budget is almost €500 million. Of this, €138 million goes on compensation for people affected by various inquiries, such as the Hepatitis C Compensation Tribunal, and €315 million goes to agencies under the departments remit. That leaves almost €50 million spent on administration by a core staff of 436, most of them based at headquarters in Hawkins House in Dublin.
It is clear from the report that many staff feel their time is misspent. It says very significant resources are devoted to serving the needs of Minister for Health Mary Harney, Ministers of State and the Oireachtas. Other organisations have succeeded in changing their focus towards serving the needs of the public, as the report points out, but the department appears to be bogged down responding to TDs’ representations, parliamentary questions and Oireachtas committees.
The department itself lists its customers as the Ministers and the Oireachtas, the HSE and health agencies and the public. But as staff told the authors of the report, most attention goes on the first two categories – the Minister and the Oireachtas – and professional representative bodies.
It continues: “This disparity between, on the one hand, who the department says are its customers and stakeholders and, on the other hand, its actual day-to-day behaviour, is a source of real frustration to many of the department’s staff, customers and stakeholders.”
The report suggests the department strengthen its relationship with patients in particular and develop effective mechanisms to obtain feedback from them.