The new chief executive of the Health Service Executive (HSE) began his tenure today with an appeal to the country's 98,000 health workers for their input into improving the service.
Professor Brendan Drumm said his first few weeks in the €400,000 per annum job would be used to assess the state of the health service and how best to utilise its €11 billion annual budget.
He said he would outline his plans for the most ambitious health service reform programme in the history of the State once this period of consultation was completed.
"While there is much that we do very well, there are many demands and difficulties ahead - we all have a lot of work to do in a relatively short time frame," Prof Drumm said.
The Leitrim-born consultant was offered the job in April after another Irish doctor, Prof Aidan Halligan, walked away for "family reasons" after initially accepting the post last year.
Negotiations between Prof Drumm and the HSE on the terms of his contract broke down in June. He wanted a guarantee he could return to work as a consultant paediatrician at Our Lady's Hospital for Sick Children in Crumlin, once his HSE contract expired in five to eight years.
Both the HSE and Minister for Health Mary Harney rejected this. Ms Harney said she "couldn't justify having a bottomless pit" to meet Prof Drumm's terms.
The impasse was finally broken when UCD offered to give him a professorship at the end of his term of office with the HSE.
Prof Drumm is now responsible for overseeing the day-to-day running of the health service and reports directly to Ms Harney. Part of the conditions he laid down in accepting the post was to be allowed to employ six hand-picked consultants.
Prof Drumm has publicly acknowledged that he now faces a "very, very difficult" task.
Among the main challenges are the shortage of Accident and Emergency beds, the impasse with GPs over the introduction of 200,000 doctor-only medical cards and the impending cash crisis in public hospitals.
He will also have negotiate new contracts for hospital consultants so they can be rostered to work around the clock, resolve the row over insurance cover for these consultants and employ more consultants.
Other priorities are restructuring GP services to take the pressure off A&E departments, freeing up more hospital beds, reducing junior doctors' hours, tackling the shortages of GPs and nurses and halting the spread of MRSA and other infections in Irish hospitals.
He also faces increasing pressure to improve services for the mentally ill and for the intellectually disabled.