Who's managing the Health Service?

It’s a basic truism of business that what you can’t measure you can’t manage.

A report by Comptroller & Auditor General John Purcell, resulting from a one-year inquiry as part of the financial audit of the Department of Health, on the contract which currently governs the work of consultants found that there was insufficient evidence to assess to what extent it was being implemented.

Indeed, there is no clarity as to how many hours per week they are obliged to work. The HSE claims 39 hours, the consultants claim 33 hours.

The report says there has been "no meaningful attempt to monitor the level of consultants' private practice for its impact on the fulfilment of the contractual commitment within public hospitals".

It also found that although there was "a belief among hospital managers that many consultants exceed their contractual commitment, this cannot be substantiated in the absence of reliable records". This may well be ass-covering by hospital managers. Who among them would be happy to admit that they have no idea what hours are being worked by the key group of employees supposedly under their command?

The Irish Medical Organisation, which represents 800 consultants, said that it welcomed the report, which "confirmed that serious difficulties are apparent in the management systems within our hospitals". It also said that the report "highlights the need for verification systems, which the IMO supports". Who believes these people?

Who is to blame here? Are the hospital managers completely incompetent or are the consultants completely unmanageable? Is the HSE capable of managing the change that is clearly necessary? Have the politicians the ability or the bottle to fix the problem? Where’s Gerry Robinson when we need him?