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Underperforming managers will not lose jobs in health


Tony O’Brien: asked to trigger new ‘get tough’ regime Picture: Tom Burke

Tony O’Brien: asked to trigger new ‘get tough’ regime Picture: Tom Burke

Tony O’Brien: asked to trigger new ‘get tough’ regime Picture: Tom Burke

Health managers who are found to be underperforming will not be dismissed or suffer a cut in salary, it was confirmed yesterday.

Health Minister Simon Harris, who is blaming the failures of some managers for the trolley crisis and spiralling waiting lists, has claimed the "get tough" regime will help weed out inefficiencies.

He told angry backbenchers at a Fine Gael parliamentary meeting earlier this week that the Performance and Accountabiltity Framework would hold senior executives such as hospital managers to greater account.

He said he intends to "shine a light on management in the HSE" in the wake of the harrowing expose of patients on waiting lists on the 'RTÉ Investigates' programme. He agreed that if HSE managers are not up to their job, they will be removed.

However, the Department of Health confirmed to the Irish Independent yesterday that this just means the manager will be removed from their post.

They will be reassigned to other duties. It means that the risk of losing their job has been removed from an underperforming manager.

The framework also has no provision for any cut in salary.

Mr Harris told the Dáil yesterday he has written to the head of the HSE, Tony O'Brien, to trigger the new system.

He said he has faith in Mr O'Brien but he did not have "blind faith" in anyone.

The Department of Health said the accountability framework which has been in place since 2015, and enhanced last year, "makes explicit the responsibilities of health service managers in relation to four areas".

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These include performance in patient access to services; access to services; quality and safety; and ensuring proper control of finances.

A spokeswoman said the framework "ensures that named senior health service managers designated as accountable officers are explicitly and personally accountable for performing within their budget allocation".

HSE national directors, hospital group CEOs and others are included in the assessment.

The national performance oversight group (NPOG) has delegated authority from the HSE director general to monitor performance.

In cases where remedial actions have been put in place to support the manager and no improvement has been made "there is provision under the framework for escalation".

"This escalation reflects an increased level of concern in relation to performance which requires more intense focus, action and scrutiny in order to bring about improvement."

The manager will be asked to produce a recovery or improvement plan, which will include detailed actions for improving performance.

It will have to set out specific and measurable actions and timelines for improvement. At that point a "graduated and appropriate regime of supports are available to managers which includes assistance to form the improvement plan".

The spokeswoman said while the focus of the escalation process will be on supporting managers to improve performance, there is also potential sanctions applied in the case of continued underperformance .

These sanctions include the issue of a formal performance notice to their relevant section.

"An organisational performance improvement plan is required in foot of a performance notice," she said.

"Where improvement is not seen within the timeframe set out in the first performance notice, a second performance notice will be issued.

"Performance notices will be published on the HSE website."

Individual sanctions will also be applied where there has been no improvement in performance within specified timeframes.

An individual performance plan will be required to be agreed with the national director or line manager.

"Ultimately where improvement in line with the performance improvement plan is not achieved, the process may ultimately culminate in the removal of the named manager from the post."

It can also see them reassigned to other duties.


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