Just finished reading Brendan Drumm’s account of his experience of leading change in Public Health in Ireland – as head of the HSE from 2005 to 2010: ‘The Challenge of Change – Putting Patients before Providers‘.
Interesting book on a number of counts: good discussion of a major change project, public health is of interest to all of us, provides an insight into implementing change in public sector and poses some interesting questions about the role of politics and politicians and their impact on provision of public services.
He is very forthright on a number of points:
- Patients (ie the public) need to demand change
- Practitioners need to lead the change
- Primary care is at the centre of any effective solution
- We do not need more beds
- Rationalisation of A&E services across the country was the only option – backed up by significantly improved ambulance services
- HSE (and therfore the public) was paying too much for drugs
- The revised consultant contract (80/20 split of public/private) work is the way forward
Clearly be believes that he has mapped out a way forward for public healthcare, that we have made significant progress during the last five years and that if the curent incumbents stay on message we will see real changes and benefits for patients in years to come.
It will be interesting to see how a number of changes play out:
- Ongoing discussions re consultant contracts e.g. reimbursement; changing role in context of 80/20 arrangements
- Further consolidation of A&E facilities across the country
- Further role out of integrated services
- How will the current Minister for Health drive forward the changes?