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The health chiefs under fire:

TONY O'BRIEN, the director general of the HSE, writes a lot of letters to government departments. They are usually warnings about budget cuts and at first they deflected criticism of the HSE when another hairshirt is revealed. But this has long worn off.

Now in his late 40s, he was hand-picked nearly two years ago by Health Minister James Reilly to take over the HSE.

There were promises of an end of large holes in the health budget – but Mr O'Brien, a former head of the Irish Family Planning Association, will not deliver on that promise this year. His greatest failure has been the inability to shake off the sluggish and uncaring image of HSE bureaucracy, which many believe has gone from bad to worse.

DR AMBROSE McLOUGHLIN was appointed secretary general of the Department of Health two years ago. Tall and grey-haired, his speeches are invariably civil-service-scripted and unlikely to be controversial.

Now in his early 60s, his performance at Oireachtas committees, where the questions are probing, are in the classic public servant mode and his answers precise but prim.

It is this approach which yesterday led to some tensions between himself and Public Accounts Committee chairman John McGuinness who asked him how much the department estimated the health service needed in funding for 2014.

Dr McLoughlin refused to say, insisting it was a question for Health Minister James Reilly. This led to a testy clash with Mr McGuinness, who said there was nothing stopping him giving the answer.

The department head's style is a little surprising given he has been around the block in 40 years, starting his career as a dentist and later joining the North Eastern Health Board, where he rose to be chief executive.

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