Turmoil as Reilly allies told to quit over €500m deficit fears
THE health service has been plunged into more turmoil after the two top officials charged with its management were told to resign.
The unprecedented call was made at a highly charged meeting of the powerful Dail Committee on Public Accounts after it emerged the Health Service Executive (HSE) is careering towards a "cash burn" possible €500m shortfall, with patients bearing the brunt.
It is yet another blow for Health Minister James Reilly who is in a desperate fight to hold on to his job in the upcoming cabinet reshuffle.
The two men in the committee's firing line – Department of Health Secretary General Ambrose McLoughlin and HSE Director General Tony O'Brien – are key allies of Dr Reilly and were appointed under his tenure.
It comes as details were revealed of how a private management consultant is being paid €258,730 – more than twice the official rate – to fill a senior health service post.
Starline Management Consulting is filling the post of assistant chief executive and chief operating officer in the mid-west, with a salary of €116,000.
At the Public Accounts Committee yesterday, a grim picture of a health service in crisis revealed:
- More hospital cutbacks are on the way from this week in a bid to rein in their massive overruns of €63m.
- No discretionary medical cards will be returned until the Cabinet comes up with a legal formula.
- At least eight health managers on salaries of €80,000 or more are insisting they have a legal right to top-up allowances.
- The review of discretionary medical cards has stopped but is continuing for all other card holders, including 65,000 over-70s.
Committee chairman John McGuinness (FF) told Mr McLoughlin and Mr O'Brien they should resign after the two men struggled to explain why the health service remains in a state of financial emergency while the HSE's actions is leaving many sick and elderly medical card holders "petrified".
The Health Minister was last night quick to defend both men, saying "it is wrong to attack the leadership who are maintaining the services in such difficult circumstances and who have my confidence".
Dr Reilly agreed the HSE as a "structure for delivering healthcare is not fit for purpose" and said that is why he is abolishing it to improve outcomes for patients.
Mr McLoughlin, who earns €176,350 a year, and Mr O'Brien, on a salary of €185,000, are both permanent and pensionable public servants. They defended their performance, saying they are contending with huge cuts in funding to the service.
A frustrated Mr McGuinness told the two men: "This is Groundhog Day. We are dealing with the same issues all the time." He called on them to resign after hearing a catalogue of inefficiencies, failure to meet financial targets and huge payments to private agency staff.
"Not only have you not reached your targets or gone over your targets but you are employing people at a massive amount of money. The public are looking in with utter disgust at how you managed the medical card process."
John Hennessy, HSE Director of Primary Care, said €5m had been saved up to April in the medical card, drugs and other schemes but he could not say how much the controversial review of cards yielded.
He confirmed that 1,190 people who had discretionary cards have had them removed since the beginning of the year, part of 8,735 who have been refused the benefit.
A number of TDs said they have had to install scanning machines to copy their constituents' medical card documents because it is a regular occurrence for the HSE to ask for the same information again.
Mr O'Brien said the medical card section deals with more than 7.8 million transactions a year and an analysis of the process is under way.
Questioned on the progress of the HSE's efforts to remove salary top-ups to well-paid managers in voluntary hospital and disability agencies – the individual payments which were first revealed in the Irish Independent – he said eight are claiming they have a contractual right to the allowance but they are being asked to prove it.
Around 58 of the 143 managers who were in receipt of top-ups still have issues but the deadline for resolution is July 1, he added.