HSE has to make this crude jobs cull work
THEY'VE left it very late to perform surgery. The patient was in a bad way and the prognosis certainly wasn't good.
But at least the scalpel is finally being wielded -- 5,000 jobs are expected to be shed from the HSE through voluntary redundancy and early retirement, mostly from the health service's oversized management and admin cadre.
Even HSE top management has admitted the massive health organisation that was set up in January 2005 has always had far too many managers and administrators.
Five years ago was, of course, the right time to thin out the top heavy admin section of the HSE.
With the amalgamation of 11 health boards into one organisation, there was obviously going to be duplication and too many people doing the same type of job.
This type of top-heavy bureaucracy got in the way or providing an efficient health service. Money that was being spent on a bloated back office staff corps could have been diverted more productively to frontline care.
The HSE is to save €200m a year from the job cuts -- it could probably have had this extra funding to spend on frontline care back in 2005 if realities had been faced at the time.
But this nettle was never grasped when the Government could really afford to do it. Now it can barely afford to do it but it has no choice.
With cuts of up to e1bn threatened for the HSE next year, if some of that is absorbed by the take-up from the redundancy programme, perhaps the frontline care cuts will be a little less severe and not as many patients will suffer.
But it's not going to be all plain sailing. Job cuts, even with reasonably generous redundancy terms that some private sector workers losing their jobs right now might envy, are always a blunt instrument.
Under the scheme, the HSE can't target specific admin and support sections that might be overstaffed and need thinning out -- it has to wait for people to come forward and hope that the necessary efficiencies and cost savings will be made.
Also, admin staff may not be health professionals, but many of them do provide very necessary services that support frontline care -- for example, doctors' secretaries, admin support in outpatients, medical records staff.
The HSE itself has warned that implementing the jobs cull will be "challenging". But it's a challenge that must be faced in these dark days for health services.
Niall Hunter is editor of irishhealth.com