Professor Brendan Drumm, who took up the post of chief executive of the Health Service Executive (HSE) last week, faces many difficulties in his new role. At the best of times, assuming responsibility for 100,000 staff and an €11 billion budget would be an onerous task.
But, with a health system in crisis, the challenges facing Prof Drumm cannot be overstated. In an initial message to staff, he spoke about visiting locations around the State and engaging directly with employees. Health service workers will appreciate this approach, but they will be looking also for him to boost morale at the coalface of clinical care.
As a former clinician, Prof Drumm brings to the post an invaluable "feel" for the difficulties faced on a daily basis by health professionals and patients. Despite his experience as the head of an academic paediatric unit and as a former chairman of Comhairle na nOspidéal, though, he is relatively untested as an administrator. He is wise to have surrounded himself with a personal team of experienced healthcare administrators and clinicians who will act as a spearhead for change. Otherwise the chances of the healthcare establishment blocking innovations and maintaining the status quo would be high.
What are the immediate challenges faced by Prof Drumm? With winter approaching, the perennial accident and emergency crisis, with unacceptable delays in admissions to hospital, is inevitable. Indeed, with the summer lull in bed demand less pronounced than usual, this winter's A&E bottleneck has the potential to be even more severe than in previous years. It would be unreasonable to expect Prof Drumm to make immediate inroads in this regard; yet, were he to announce some innovative ideas to solve the problem in the longer term, it would undoubtedly help to establish his authority.
The European Working Time Directive (EWTD), under which the working hours of junior doctors are to be reduced, has not been fully implemented. This, in turn, creates a demand for more hospital consultants, who cannot be recruited until the common contract has been renegotiated. Both the EWTD implementation and the consultant contract negotiations are complex areas, ripe for industrial unrest. And that is before Prof Drumm addresses the concerns of nurses and paramedical staff.
Health Minister Mary Harney has not prioritised general practice and community health, but Prof Drumm would be wise not to ignore this sector. It holds the key to the long-term health of the population. Only by investing in it and addressing manpower problems in general practice will pressure be taken off the hospital sector.
Ms Harney recently indicated that she needs seven years to turn the health service around and Prof Drumm will be acutely aware that he has just five years to make a difference. He deserves the good wishes of the public, health professionals and politicians as he undertakes one of the most difficult challenges in Irish public life. Patients, most of all, will hope that he succeeds.