Sir, - The resignation of David McCutcheon will have ramifications for healthcare management in this country for many years.
The traditional system whereby health services have been developed in a piecemeal fashion with little real thought or consideration given to a long-term strategy has led to a fragmented service which best serves the interests not of patients, but of local politicians and empire-building doctors.
It was to be hoped that the appointment of Dr McCutcheon represented a break with the past and a focus on a more professional management approach to our health service with a truly patient-focused approach. His overriding objective of managing the cultural merger of the four institutions onto a greenfield site has largely been successful and will serve as a fitting testament to his ability long after he has left.
That a hospital almost 30 years in the planning, five years in the building and open barely six months can lose its chief executive due to a current account budget over-run is equally a testament to the real culprits in this matter: the Department of Health and within it those faceless people responsible for the hospital's budgetary allocation.
Adding the pre-existing hospital budgets together and adding on a bit more for good measure without realising the extra demands that the hospital would face in relocating to what is effectively a city within a city was simply not good enough. Surely it should have been possible to predict or at least make some provision for this demand, which seems to be at the heart of the current funding crisis.
The honourable action of Dr McCutcheon in resigning contrasts starkly with the "deflect blame-at-all-costs" approach of the Minister and his officials. One question persists: if the chief executive is prepared to resign because of the current account overrun, who in the Department is minded to resign because of the capital expenditure overrun and the delays which have dogged this project since its inception in the early 1970s?
The final and probably most damaging result of this debacle is that it will convince potential senior managers, both medical and non-medical, that a career in the Irish healthcare system is best avoided. Do not be surprised when similar mistakes are made in the future. - Yours, etc., Dr Shane Corr,
Killiney Towers, Killiney, Co. Dublin.