Magahy cited slow progress in key areas of reform in resignation letter

Sláintecare executive director Laura Magahy said there had been "slow progress" in "three key areas requiring dedicated, focused, reform effort" in her letter of resignation to Minister for Health Stephen Donnelly last week.

She said the three areas were proposed new regional structures for the health service, eHealth – or using technology to enhance services – and waiting lists.

She suggested that new governance and oversight structures must be put in place, given the large sums of additional funding being provided by Government to the health service.

In a separate letter to the management board of the Department of Health, she said she understood the HSE wanted to defer the implementation of proposed new regional health areas.

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However, Ms Magahy said “it is my considered view that reform cannot happen without devolution of budgets on a population health basis, and clinical oversight on a regional basis, with supporting eHealth solutions”.

Ms Magahy and the chairman of the Sláintecare Implementation Advisory Council Prof Tom Keane resigned suddenly from their roles last week, casting doubt over the future of the overall health reform programme.

Mr Donnelly met remaining members of the Sláintecare Implementation Advisory Council who had sought details from him regarding the background to the resignations.

Council member and former general secretary of the Irish Nurses and Midwives Organisation Liam Doran said the meeting had been "frank".

However, he said he was none the wiser afterwards as to why Ms Magahy and Prof Keane had resigned. He said he had no sense that the Minister or the Government was of a mind to reset or renew in any tangible way its commitment to Sláintecare.

In a brief statement, the Department of Health described the meeting as “productive”.

It said the Minister had outlined the Government’s commitment to the implementation of Sláintecare and that a range of issues around the continued process had been discussed.

The Government has insisted that it is committed to implementing the Sláintecare reforms although the Minister said he agreed with the HSE that the timing was not right for major structural reforms of the health service in the middle of a pandemic.

‘Seriously lacking’

Ms Magahy said in her letter of resignation to Mr Donnelly, dated September 7th, that there had been “good progress made in many important areas within the Sláintecare implementation strategy and action plan”.

“You will see, however, that progress has been slow in three key areas requiring dedicated, focused, reform effort: regional health areas; eHealth, and waiting lists.

“These are the areas on which substantial reform depends. It is my view that these reforms require a governance and oversight structure other than that which exists at present, in particular in light of the substantial additional funding being allocated towards the reform of the health services.

“I am resigning as executive director of Sláintecare, but as discussed this morning I will be agreeing an orderly transition with the secretary general, and I sincerely wish the Sláintecare programme every success for the future.”

In a letter earlier this month outlining the reasons for his resignation as chairman of the advisory committee, Prof Tom Keane said: “Sadly, I have come to conclude that the requirements for implementing this unprecedented programme for change are seriously lacking.”

Neither Ms Magahy nor Prof Keane have spoken publicly about their departures from the Sláintecare programme.