What issued did HSE ddress when formed?

Snacker

Hi im trying to do an essay for college on restructuring organisations can anyone link or explain generally what structural changes were made when the health boards were abolished and the HSE was formed

Dr Galen

Doing peoples homework is not what this forum is for tbh

Cheers

DrG

Dr Galen

Moved from Politics

I've had a chat with this poster via Pm, and this is likely a better home than Politics tbh

Cheers

DrG

drzhivago

Snacker wrote: »

Hi im trying to do an essay for college on restructuring organisations can anyone link or explain generally what structural changes were made when the health boards were abolished and the HSE was formed

Unsure of thrust of question BUT
we had 11 health boards
Merged to form HSE
NO staff layoffs
Multiple duplications of roles

New Stationary
New Logos
New signs on buildings
New Supervisory management roles

Centralised a lot of things that used to be done locally taking decisions away from local decision makers

Budgets brought back under central control but responsibility for overspend sent out to the peripheries

mathepac

The sole political purpose of the HSE was to insulate politicians and civil servants from any responsibility for the execution of policies set by the Dept of Health and Children (or whatever they are currently called).

This new monolithic HSE would save asses and embarrassment, but not anything as trivial as money. Freed up from everything to do with health delivery, there were supposed to be fewer civil servants in DOHC; today there are more.

One of the more ill-informed and ham-fisted attempts to centralise control over the personnel costs in the new HSE (the single biggest line-item in the annual budget) and to drive organisational change was to roll-out an IT system called PPARS, a "high-tech, super-duper payroll and personnel records system". No-one understood that PPARS was a cube and couldn't roll very far, so it didn't.

The planners / implementers forgot (or never knew) that information technology is non-deterministic and in order to be successful, it must "fit" with the human work-systems. IT cannot be used to design work; work and workers define IT design. The work-systems themselves of course evolved from the days when the county councils and voluntary organisations ran the majority of the hospitals in the country and were by and large stuck firmly in the 19th century.

So we are now witnessing the demise the the "big HSE in the sky" and quietly behind the scenes the health delivery model is now reverting to what it was before Harney Drumm & Co got their paws on it, with mini-HSEs all over the country again with their own mini-boards.

Professor Charles Handy in his books lists I think 68 variables that need attention when designing effective / efficient organisations; structure (who reports to whom) is only one of them and one of the least important in his view. The critical one is "purpose" or "what do my customers / clients expect of me". I can't remember HSE users being asked by Harney Drumm & Co, but I'm sure politicos and civil servants had their input.

opinion guy

I don't believe anyone in managment grades of the HSE knows anytihng more about computers than how to email, write word documents and play solitaire. The people making decisions on IT in the health service are taken in by marketing spiel of salesmen because they just don't understand enough about IT not to be taken in

Delancey

One thing the HSE did reduce was the shocking level of political interference in the provision of health care - the old health boards were stuffed with local politicians who constantly badgered management about '' why is mrs. murphy waiting 12 months for her hip replacement ? '' .
A British NHS trust CEO spent time here with a Health Board and was shocked at the political interference at all levels.

Take a look at the Cancer care strategy - this has involved shutting down various ' Mickey Mouse ' operations and going for the centres of excellence strategy , the howls of protest have been loud but the strategy has proceeded and this could never have happened when local politicians, many with Dail ambitions , were calling the shots.
I believe the new strategy will pay dividends and our cancer outcome rates will improve.

That said , the HSE has been called the Quango from hell , it lacks accountability , is overstaffed , many managers remain poorly educated and trained , patients still come a poor second to the needs of staff , etc.