‘Impatient’ new HSE boss says system is too slow and risk-averse

Bernard Gloster. Photo: PA

Eilish O'Regan

Newly-installed HSE chief Bernard Gloster described himself today as “very impatient”, saying the organisation is too slow as well as “risk-averse” in getting things done, which is hampering the service for the public.

He questioned why around 600 patients who no longer needed medical care were occupying beds this week as hospitals faced severe overcrowding, and said while there are complex reasons for some delays it is not the case for all.

The former Tusla head said he intends to speed up decision-making and ensure a faster pace of delivery.

His natural impatience can be a potential weakness or strength, he said.

“We have become risk averse. We want to think about the decision for a very long time. We want to study and analyse it. Sometimes that is good and we don’t want to make decisions flying by the seat of the pants but we do have to do it in a timely pace,” he told the Oireachtas Health Committee.

He said if he sees something working well in one area of the country he is obliged to inquire why it is not working somewhere else.

“Very often we have the answer but are  fearful of scaling it,” he added.

Mr Gloster said he has taken the €367,000-a-year job for five years and intends to stay the course.

He was questioned by Sinn Féin TD David Cullinane on new figures showing that 1,228 hospital beds announced in October 2020 will take four years to deliver.

There were 970 delivered to the end of 2022, another 207 are promised this year and 49 will not be in place until 2024.

Deputy Cullinane said he accepted Mr Gloster was “just in the door” but if there is to be confidence from the public the pace must be stepped up.

Mr Gloster said he could cite pressures such as construction sector problems but he will find out what part the HSE played in the delay and try to stop it happening again.

He insisted, however, that more beds on their own are not enough, and patients will not see the benefit if processes and practices in the health service are also not improved.

“We have process and practice challenges in most parts of our system that require significant step change in how we deal with them,” Mr Gloster said.

He is shaking up the centre of the HSE and bringing the managers of hospital groups and community organisations together beginning from next month to be part of top-level decisions.

There will be an emphasis on ensuring that good practice is implemented across the country.

He also conceded the winter plan, produced every October to deal with upcoming pressures, is probably past its usefulness and what is needed now is year-long plan to reflect the fact that hospitals are operating at “full tilt” through every month.

He said priorities this year will be in improving access and tackling emergency care.

Mr Gloster said that it is “important to accept that while responding to many issues over the years the HSE has become a top-heavy structure with many cumbersome processes. Structure itself however is not an answer on its own,” he said.

“While there are well evidenced capacity and demand issues to be addressed and there are good plans to do so, there are also process issues to be improved and with decisive management and leadership these can and will be tackled ahead of any structure changes.”