Senior figures associated with the Sláintecare health reforms plans were unhappy at delays by Government in implementing proposed radical changes to HSE structures over recent months.
There were also concerns over governance issues associated with Government plans being drawn up for tackling rising hospital waiting lists, The Irish Times understands.
Taoiseach Micheál Martin said on Friday morning he would be seeking a meeting with the two senior members of the Sláintecare management team who resigned this week "to get their perspective".
The executive director of the programme office Laura Magahy and the chair of its implementation advisory committee Tom Keane both resigned, it was announced on Wednesday.
Work on drawing up the new plan on hospital waiting lists involved the HSE, Department of Health, the National Treatment Purchase Fund as well as the Sláintecare office, and there were issues in recent months about which body would be responsible for which elements and reporting structures.
Highly placed figures confirmed on Thursday night there had been fierce disagreements on the issue.
‘Seriously lacking’
Prof Keane said in his letter of resignation that he had "come to conclude that the requirements for implementing this unprecedented programme for change are seriously lacking".
Mr Martin said the HSE had in the past year been absorbed by Covid. It had been “all hands on deck” and “huge resources” had been put into health, he told RTÉ Radio’s Morning Ireland.
When asked about the previous recommendation that Sláintecare should come under the auspices of the Department of the Taoiseach, Mr Martin said that the Taoiseach’s office did not have “the band width” for such a programme.
Sláintecare would have the be “embedded” within the HSE too, he said.
The Government was prepared to double the resources to public health, he said.
Other aspects of Sláintecare had been delivered and significant changes had occurred, he added.
Minister for Health Stephen Donnelly said he was sorry to see Ms Magahy and Prof Keane leave as they had performed "amazing work". He said "great progress" was being made in implementing the reforms.
The backdrop to the resignations involved frustration at a perceived slow pace of change and the level and layers of bureaucracy that had to be dealt with to implement the proposed reforms.
Progress
Members of the Sláintecare Implementation Advisory Committee met with and subsequently wrote to Mr Donnelly earlier this year urging him to progress planned changes to HSE structures, which had been announced by his predecessor Simon Harris in July 2019, on the basis they were fundamental to the reform programme.
However, the HSE was opposed to changing health service structures in the middle of a pandemic and the Minister ultimately supported this view, it is understood.
Sources close to Mr Donnelly said the planned health structural changes had not been taken off the table, but rather it was an issue of timing.
The plan would have involved the introduction of six new streamlined regions with greater autonomy over budgets to oversee both hospital and community services.
Members of the advisory committee are expected to question the Minister on why a promised briefing to the committee on the Government’s plans for a new Sláintecare contract for hospital consultants did not take place ahead of talks with medical organisations. A number of members resigned from the advisory committee over the issue this summer.
