Ombudsman’s report - HSE is hurt by corporate omerta

IT is unlikely that the thousands of people who enjoyed positive experiences when, in their moment of difficulty, they turned to our health service, wrote to ombudsman Emily O’Reilly to put their gratitude on record.

However, anger being a far more provocative force than relief, more than a quarter of the 2,873 complaints filed with the ombudsman in 2009 relate to health services. Some described situations which Ms O’Reilly characterised as “shocking and unacceptable”.

Her office dealt primarily with complaints on treatment or fees but she took the opportunity to criticise on the culture of secrecy and self-preservation that remains the organisation’s default position. She accused the executive of being “riddled with excessive secrecy” and said it seeks to protect its interests rather than serve the public interest by being transparent.

These accusations are not new and have been made by angry Dáil deputies who failed to get answers to perfectly legitimate queries regarding their constituents.

That corporate omerta came in for criticism in recent weeks too when reports on the death of young people while in state care were not made available. The immediate impression was that the HSE was sitting on the information to protect itself and though some clarity has been brought to the situation that suspicion has not been completely lifted.

Defending the Health Service Executive position outgoing chief executive, Brendan Drumm, said that they had no discretion in this matter as they were precluded by law for publishing anything that might identify or jeopardise vulnerable young people.

Thankfully this legislation is being reviewed because there is a very strong feeling that it is being misused to protect the indefensible.

When Cathal Magee, a former Eircom executive, replaces Prof Drumm in two months time he will face a great number of challenges.

Two of the main ones will be providing improved services on a reduced budget and reforming an organisation that has stymied change for far too long.

Another will be changing the perception that the organisation, with a budget of €15 billion and a staff of 110,000, has assumed a regal disposition and imagines itself unaccountable.

Of course his priority must be value-for-money patient care but, as Mr Drumm might confirm, he will spend far too much of his time and energy defending the organisation unless a new culture of accountability is put in place and rigorously observed.

Last year, the civil service accounted for 41% of complaints received by the ombudsman, with local authorities accounting for another 30%.

Earlier this week, the general secretary of the Irish Congress of Trade Unions, David Begg, was involved in a debate on the public finances. He urged that we spend our way out of our economic crisis as his opponents argued that further cuts were inevitable.

During the debate Mr Begg asserted that the “public service was a done deal” and that it should no longer be the focus of attention it once was.

The ombudsman’s report suggests otherwise and that Mr Beggs optimistic position is premature.


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