Irish Examiner view: An unhealthy business model

Hospital management

Prof Muldoon pointed out that the management model being applied to hospitals was based on the needs of the private business sector, a completely different arena with very different requirements, and operated on what she described as an alluring idea.

Congratulations are due to Orla Muldoon for pointing out one of the key problems with Ireland’s healthcare system.

This week, Prof Muldoon pointed out that the management model being applied to hospitals was based on the needs of the private business sector, a completely different arena with very different requirements, and operated on what she described as an alluring idea: That if one managed things better one could achieve more with the same money.

This notion has served generations of management consultants well but neglects one obvious fact — that the successful performance of a hospital in treating its patients is not comparable to the successful operation of a business in the open marketplace.

Prof Muldoon also pointed out the slavish adherence to key performance indicators, or KPIs. 

The KPI may be a useful tool in benchmarking pay, or perhaps in sports punditry, but one must question its utility in the healthcare sector. 

One of the examples used by Prof Muldoon was a a list of KPIs used by the HSE, which runs to 122 pages. A starker example of a management culture run amok would be difficult to find.

The acceptance of such a metric within an organisation has an unfortunate consequence in that it helps to generate a management class to oversee the application and measurement of the KPIs. 

In a health service with little spare capacity to begin with, resources which need to be devoted to the internal KPI industry cannot, obviously, be devoted to patient care.

Prof Muldoon is to be commended for pointing out an obvious problem in the health service.

It remains to be seen if there is any change in the culture of the organisation as a result.