White paper is no cure for health system ills
The white paper has great detail on treatments and new administrative structures to manage them.
But it does not discuss how delivery of frontline healthcare can be fixed, nor the systematic changes that would improve patient safety. Lessons are not being learned in the context of the management culture and processes within the health service.
All that seems to matter in Irish public life is the attainment of power and the maintenance of the status quo. A similar analysis could also be applied to the management culture in the public sector. Making grandiose plans for changes in the public service is pointless unless frontline delivery is improved.
Too much bureaucracy, relying on reduced numbers of administrative staff, working with outdated IT infrastructure, adds unnecessary pressure to frontline staff in maintaining the provision of services. This scenario is not compatible with the provision of quality healthcare and the assurance of patient safety.
True change in the health service needs a radical investment in IT infrastructure, a rationalisation of administration, accountable objectives and the introduction of a lean management culture that embraces change.
In other words, an investment in the long-term sustainability of the service. This would free up resources and prioritise frontline delivery, enhancing the quality and safety of healthcare.
Unfortunately, none of the references in the white paper to the words ‘risk’, ‘safety’ and ‘culture’ were in the context of improved frontline delivery of care through reform of systems. The white paper describes many new structures, but makes no provision for a change in systems.
Yet again, a much-heralded change in the public sector fails to address the real issues hindering efficient provision of services and allows the threat of privatisation to gain traction.
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