Hospital chief says public bosses ‘not as accountable’
Deputy chief executive of the Beacon Hospital, Brian Fitzgerald, who previously worked as chief executive of St James’s Hospital, said public health management are not as accountable.
Mr Fitzgerald told members of the Oireachtas committee on the future of healthcare that he is “kept on his toes” in his current job.
“Was I kept on my toes every hour, every day in the public system? Perhaps not,” he said.
Mr Fitzgerald said the management team at the Beacon presents a plan every year to the board, which examines it and makes amendments as it sees fit.
“We are measured every month on a whole ream of performance indicators,” he said.
When he worked at St James’s, Mr Fitzgerald said he did not experience that level of scrutiny, which he described as “precision governance”.
“When I refer to accountability, the reality is if we (Beacon management team) don’t perform there are inevitable consequences to that. It is no different to any other private business.”
Mr Fitzgerald said he had reached a stage in his career where he felt he could not credibly comment on health unless he spent some time in the private system.
He said he feels that people who work their way up in the public healthcare system are at risk of becoming stale in their mid-forties because it is a permanent and pensionable job.
He found that working in the public healthcare system created a psychological block to making innovative decisions.
Róisín Shortall, chairwoman of the committee, said two factors must be borne in mind: The complexity of the work done in the public health system, and that accountability within the public sector is not all it should be.
“And I think we would all accept that,” she said.
Mr Fitzgerald told the committee it is unlikely more private hospitals will be built because they are reliant on contracts from private insurers.
“Based on past conversations with health insurers, there is no appetite to give new contracts for new beds,” he said.
