It's back to the drawing board yet again for Mary Harney, writes Eithne Donnellan, Health Correspondent
Getting an outsider who was willing to take on the unenviable task of running the health service and be responsible for its €11 billion annual budget was never going to be an easy task.
The idea was that a new broom would sweep clean and give a fresh impetus to changes planned under the Government's health service reform programme.
Mary Harney knew, when she became Minister for Health, that getting the right leadership for the Health Service Executive would be key to any success she might enjoy in her post.
A major recruitment campaign began last year to find a person who would lead these changes and the preference was to find somebody not already in management in the Irish health sector.
The person found would be appointed to the post of chief executive of the new Health Service Executive (HSE), established in January following the abolition of the health boards.
A suitable candidate was found by September last. He was Prof Aidan Halligan, deputy chief medical officer of the British National Health Service. However, two months later and shortly after the appointment of Ms Harney as Minister for Health, he withdrew from the post, apparently for family reasons.
The news was a major blow. Expectations among the public that they would quickly see a better health service as a result of it having a new leader, and among the 98,000 employees working in the sector that they would have a new boss, were dashed.
It was decided that the health board chief executives would stay on and run services in their own regions until this month, by which time it was hoped the HSE would have found a replacement CEO.
A recruitment process began again and a number of people were asked if they would consider putting their names forward for the job. Prof Brendan Drumm, a consultant paediatrician at Our Lady's Hospital for Sick Children in Crumlin, Dublin and a professor of paediatrics at UCD, was one of those and ultimately he was successful. His appointment as chief executive designate of the HSE was announced two months ago.
Again his appointment was welcomed. He was well-liked by patients and those who worked in the health sector and he was seen as someone never behind the door in speaking his mind when he felt services needed to be improved.
Now, however, negotiations with him on a final package for the post he was due to take up in the autumn have also fallen apart.
Oscar Wilde springs to mind. To lose one doctor who was prepared to take over an unenviable task might have been unfortunate, but to lose two sounds like downright carelessness.
Prof Drumm said yesterday there had been several sticking points in his negotiations with the HSE. He wanted to bring with him a team of six people who would concentrate on reforming the health service immediately while existing managers in the sector concentrated on day-to-day firefighting.
While some saw this as a threat to their positions, it was eventually agreed he could bring a team with him.
Other than that, he said the package he was offered was similar to that offered Prof Halligan - a salary of €320,000 a year plus a potential bonus of €80,000 and a pension. His contract would be for five years, and may then have been extended to eight years.
He made it clear from the beginning, once he was offered the post in April, that he wanted a guarantee he could return to clinical practice once his contract expired. He said he didn't expect his job to be held for him but he expected to be able to return to UCD as professor of paediatrics and he said there were several departments in the university with more than one professorship. He didn't expect to be head of the paediatrics department there again, he just wanted to go back as a professor so he could continue to treat, teach and engage in research in Crumlin hospital.
The negotiating team, representing the HSE, the Minister's office and the Department of Health would not agree to this. They said they could not fund such a post for him to return to.
This seems like a relatively small matter for the whole deal to fall apart on.
The Minister has said, and rightly so, that she has to protect the taxpayer and seemed to be suggesting that he was being too greedy.
But Prof Drumm claims there is a precedent for what he is seeking. He says masters of maternity hospitals return to their jobs once they have served their term, directors in the HSE are on contracts which entitle them to go back to their original jobs after five years. And when administrators in the health sector were worried about job losses after the reforms and were threatening industrial action in December, they reached a "jobs for life" deal with the Department of Health.
Therefore it seems strange that a man prepared to take on one of the most difficult jobs in the State, at a time when the health service reform programme badly needs a leader, should be allowed to walk away from it over a relatively minor matter, and over an amount of money which is small compared to the amounts wasted on electronic voting, not to mention the nursing home charges fiasco. Why this was allowed to happen has yet to be fully explained.
The repercussions for the Minister, who is ultimately responsible, are likely to be enormous. She is already being criticised for failing to deliver any real improvements in A&Es, for trying to introduce retrospective legislation to legalise nursing home charges, medical card numbers have dropped since she took on the health portfolio and she has recently admitted she doesn't have money to implement all the strategies and reports drawn up for her department.
And now her reform agenda is back to square one again. No real change has actually occurred since the HSE took office and it seems none is now likely for another considerable period.