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The HSE is in crisis, the public has lost confidence and this is the man tasked with saving it. Here's the 10 things he must do now

AFTER a long search, Cathal Magee may well be the right man for the thankless task of transforming the HSE into an efficient organisation.

An organisation where promises that the patient will always come first are not simply rhetoric.

A high achiever with Eircom, where he helped restructure the telecoms body, he is said to have a conciliatory approach in dealing with staff and in trying to bring them on board in any reform process.

However, the challenges he faced at Eircom pale into insignificance with what he will face at the HSE.

For a start, Mr Magee has to shed thousands of jobs from the health body, while trying to reform some work practices, and to improve how increasingly pressurised services are delivered at a time when the kitty is empty.

Most of all, Cathal Magee needs to 'rebrand' the HSE. Despite the millions spent on advisers, consultancies, reports and bonuses, public confidence in our health service is at an all-time low.

So what should the new HSE chief do?

1 Change the name. The HSE is a failed brand and needs a new image. A name-change to 'Health Ireland', for example, should go hand in hand with a leaner and more efficient and responsive health organisation.

2 Okay, changing the name on the tin will only get you so far, but it's a start. You then have to rid the HSE of much of its bloated middle and higher management while ensuring that cuts in frontline staff are kept to a minimum. And do something about the "blunderbuss" approach of the recruitment freeze to ensure that key frontline and management staff are replaced.

3Make sure everyone who works is in a management or governance post within the HSE knows what their responsibilities are and that they will be held accountable when things go seriously wrong. It's important to learn from mistakes, but the buck has to stop somewhere.

4Make sure that voluntary hospitals are properly accountable to the HSE for their performance.

5 Get staff and the public to 'buy in' to the HSE project. Despite its flaws, there's considerable public and staff pride in the UK NHS. We need a sense of common ownership of our health service, rather than feeling it's just some faceless bureaucrats counting beans and issuing diktats.

6 Improve transparency. Make the HSE board hold its meetings in public for a start. Adopt a more open approach to safety, quality and cleanliness/infection. Publish league tables of hospital performances under these headings. Give more autonomy to local regions -- the changeover to a single health body has left a democratic deficit.

7Give every patient who attends a hospital a complaints/compliments card to fill out, and act on the findings.

8Put the brakes on the current plan to slash beds ahead of adequate alternative community facilities being provided to replace them. No bed should be closed unless high quality and safe patient outcomes can be guaranteed after it's gone.

9Set up real action plans with targeted resources to end the remaining A&E trolley wait "blackspots" and to cut the 175,000 patients on outpatient waiting lists.

10Undertake a major review of the HSE's social service and childcare functions.

Above all, never put bean-counting, no matter how difficult the financial situation, ahead of a satisfied and safe patient or client.

Niall Hunter is editor of irishhealth.com


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