Major HSE reshuffle already under way as Tony Holohan bids farewell and Paul Reid begins countdown to his exit

She will guide and advise on public health, including Covid-19, on an interim basis until a permanent CMO is appointed in September.

Deputy chief medical officer Dr Ronan Glynn has already gone for a post in EY consulting.

The Department of Health has a number of deputy chief medical officers and among those taking on some of his responsibilities are Dr Collette Bonar and Dr Des Hickey.

Asked about what the changeover will mean for the Covid-19 advisory group, as Ireland grapples with a summer wave of the virus, a spokeswoman for the Department of Health said Dr Smyth will take Dr Holohan’s place as its leader.

The group was set up to succeed the National Public Health Emergency Team (Nphet) which was disbanded after the emergency phase of the pandemic.

However, it was confirmed yesterday the advisory group has only met on two occasions despite being set up in early April.

The spokeswoman declined to say who has replaced Dr Glynn but said the group will continue to meet “on a regular basis”.

She said Dr Smyth will formally take up her role as interim chief medical officer, and its associated responsibilities, from July 4, next Monday.

The tensions and personality clashes between Dr Holohan and HSE chief executive Paul Reid during the pandemic are set to fade into the background now but the strains between officials responsible for policy and those who must execute them will no doubt continue.

The announcement by Mr Reid that he will step down in December, ahead of the May 2024 end of his contract, means for much of the remainder of the year there will be a spotlight on who will be his successor.

Once a departure is announced the dynamic inevitably changes.

Mr Reid is expected to maintain a firm grip on HSE operations but the reality is that once someone announces they are leaving a job the tone alters.

Whatever their statements, they have already made it clear they do not have a future stake in decisions or will be around to answer the outcome.

Within the HSE, changes have already happened with the exit of the highly regarded Anne O’Connor, its chief operations officer, who has taken up a post with VHI.

Ms O’Connor was a mine of information on everything from trolley waits in hospital to home-help shortages.
Her place is being taken temporarily by Damien McCallion, a senior HSE executive who is highly esteemed, with a strong track record, having overseen the overhaul of CervicalCheck and then the Covid-19 testing and tracing roll-out in the face of public demand and high levels of infection.

Liam Woods, who is a HSE veteran and held several roles, most recently director of acute operations over hospitals, will now be implementation lead for Sláintecare.

The big question is whether the new HSE chief will be chosen from inside or outside the public service.

So far, two of the heads of the HSE came from outside the health service with experience in overhaul involving change management.

Whoever takes over in January 2024 will need these change-management skills as the planned transition – a dilution of power from the centre of the HSE to six regional authorities, operational by 2024 – becomes operational. This will not be seamless and could be potentially fraught.

Whoever takes over these jobs permanently carries the burden and responsibility of the care of the public in their hands – be it from the risk of Covid-19 to the rising threat from overcrowded emergency departments full of very sick patients who need a hospital bed to the child who desperately should have speech-and-language therapy.

As Dr Holohan departs, there was consolation yesterday from the latest Economic and Social Research Institute (ESRI) Covid tracker survey. It found the “majority believe policy response during the pandemic saved thousands of lives and protected the economy”.

The estimated public deaths would have been “significantly higher if no public health measures were introduced rather than if no vaccine had become available”, it added.

---