What’s going on in the west?

There was an interesting exchange in the Seanad yesterday

Senator Trevor Ó Clochartaigh: Yesterday, the Minister for Health, Deputy Reilly, addressed the Seanad about the reconfiguration of maternity services across hospital groups. He mentioned issues surrounding the procurement of the report which examines this. It has subsequently been brought to my attention that there may be serious repercussions to this statement and the Minister was not fully open or transparent with the information available to him. I understand the report to reconfigure maternity services was commissioned to a company called the Health Partnership, and worker representatives believe the report will result in the closure of maternity centres in Portiuncula Hospital at Ballinasloe and in Letterkenny, with the possible downgrading of other services in the group.

The company was set up by the current chair of the hospitals group, Mr. Noel Daly. Mr. Daly was appointed chair of the group by the Minister, who expressed full confidence in him at the time.

An Cathaoirleach: I ask the Senator to refrain from naming people on the record of the House who are not here to defend themselves.

Senator Trevor Ó Clochartaigh: He is the chair of the hospital group in question and involved with the company which produced the report. It would appear there may be a major conflict of interest in the commissioning of the report, and the Minister must make a clear statement that the report is to be withdrawn completely, with Mr. Daly to review his position as chair of the board. When appointing chairpersons to the hospital group, the Minister identified a number of key responsibilities, including ensuring compliance with the code of practice for governance of State bodies, undertaking an assessment of the composition, competency, profile and potential conflicts of interest—–

An Cathaoirleach: The Senator cannot make allegations against people. Is there a question?

Senator Trevor Ó Clochartaigh: I am stating what the Minister has said.

An Cathaoirleach: Is there a question for the Leader?

Senator Trevor Ó Clochartaigh: I have a number of pertinent questions for the Leader. The person in question, the chair of the north-west hospital group, set up the company in 2004 and also appeared to be involved in plans to develop the €75 million Wyndale Clinic which was to be located on the grounds of Letterkenny hospital.

I have some serious questions to be addressed by the Minister. I propose an amendment to the Order of Business that the Minister come to the Seanad today to answer these questions. Does he agree that the report into the reconfiguration of maternity services in the west and north west cannot be relied upon as independent and fully accountable, and will he ask for it to be withdrawn immediately? Does the Minister feel the chairman of the group should review his position? What is the nature of the relationship between the Minister and the chairman of the west and north-west hospital group?

An Cathaoirleach: That is completely out of order as you are reflecting on an individual.

Senator Trevor Ó Clochartaigh: What connection, if any, does the chairman have with Fine Gael?

An Cathaoirleach: I could rule the amendment out of order if the Senator continues.

Senator Trevor Ó Clochartaigh: It is very important as the Minister was not forthcoming when he had an opportunity yesterday to address these issues. He brought up the procurement issue but he did not give us the full information he should have. We have seen decisions taken with Ballinasloe—–

An Cathaoirleach: What is the proposed amendment?

Senator Trevor Ó Clochartaigh: I ask that the Minister comes before the House to give us a full, frank and transparent report on the issues surrounding procurement of the report which considers the reorganisation of maternity services in the west and north west, as well as any matters around the chairmanship of the board. What is the appointment process for the chairpersons of boards? Was that process carried out through public appointment? I understand it was not.

Here are some extracts from an excellent article by Marie O’Connor. It gives a very clear picture of what began under Micheál Martin and Mary Harney. A destruction of public services in the pursuit of profit which has moved up several gears under doctor, minister and businessman James Reilly.

Beaumont Hospital recently announced that it was closing one operating theatre a month on a rolling basis. Yesterday the HSE admitted that it might have to close the Lourdes maternity unit altogether because of a shortage of doctors. Despite the fact that in many specialties we have a dire shortage of medical consultants, plans are afoot to slash the number of doctors in training by 900 –– around one quarter of the current total.

By last December, almost 2 500 graduate nurses had applied for work abroad because of the ban on recruitment. Our GP ratio is one of the worst in Europe, our bed to head ratio – the number of acute public hospital beds per head of population–– one of the worst in OECD countries.

Not content with this level of scarcity, the government plans to close small-to-medium sized public hospitals across the country. Mullingar Hospital is one of them, as is St Luke’s, Ireland’s specialist centre for cancer care for many decades…That Bill has just gone through its second stage in the Dáil. Last week the HSE denied that 24 beds had been closed permanently at Naas General Hospital. These are just some of the 1 200 public hospital beds closed across the country, according to the nurses and midwives’ union. They say the numbers on trolleys are now at their highest since 2007, when the body count was declared a ‘national emergency’.

HSE also denies plans to cut hospital A&E department to ‘office hours only’. We are just two weeks away from D-Day, when ‘junior’ hospital doctor contracts expire. Only on 1 July will it become clear if Naas Hospital will continue to have a full-time A&E service. Hospitals in Ballinasloe, Castlebar, Tralee and Letterkenny are in the same boat.

We are now facing the biggest closure of beds and services since the public hospital asset-stripping of the 1980s. Our public health system is being stripped out by stealth under the banner of ‘transformation’. Like‘reconfiguration’ and ‘reform’, these are weasel words for Government bed-cutting programmes

[…]

The privatisation of public administration is reaching ridiculous lengths. The decision on the location of the planned new hospital in the north-east was outsourced to a firm of private consultants, the Health Partnership. The firm has two principals: one of them is Noel Daly, a former CEO of An Bord Altranais. His firm has advised on at least seven developer-led health care projects in Ireland, including the Vista Primary Care Centre in Naas. Entrusting such a sensitive decision as where to locate a regional hospital to a company with such a strong profile in the private sector raises the possibility of conflicts of interest. In the event, the Health Partnership decided to locate the new hospital in Mr Daly’s own home town.

[…]

Health ‘reform’ is synonymous with privatisation. It is driven, not by evidence, but by ideology, belief in a model that has failed spectacularly in the last couple of years, the market model. Privatisation requires the closure of public services. Strategic management has produced reports and devised tactics, such as the cancer and chronic disease stratagems, all dovetailed to secure public service cuts. These cuts create business opportunities for powerful interests that serve commercial needs, not patient welfare.

Our health system, I believe, is being recast in an American mould. We are witnessing a massive experiment driven, not by science, but by greed. The walls of the public health system are being pulled down from within. Cost cutting is now being used to drive transformation, and transformation, as we have seen, is a Trojan Horse crammed with private for profit soldiers

 

So who or what is Health Partnership?

The website doesn’t offer much. Plenty of management speak but it all feels a bit for show really.  In fact, if you check the address provided they don’t even have an office. The one listed, 6/9 Trinity Street, Dublin 2, Ireland, is owned by this service –

Having a business address helps present a more professional image. Your business will be perceived as being bigger/more substantial which helps open doors when dealing with larger companies. It can also be useful when trying to win business in Dublin if you are based outside of the county or country. For instance, Dublin customers may be more comfortable doing business with companies who have a Dublin presence themselves.

A professional Business Address costs a fraction of an actual office and there are no hidden fees. You get all the benefits of a prestigious business address without the associated costs or hassle. The main benefit is no crippling overheads in the form of rent / rates / utility charges for office space. We can also offer meeting room hire, daily office hire on a “pay as you go” basis at your address.

Not bad for a company presiding over the potential closure of regional hospitals no?

They were also part of the “private consortium” involved in the new children’s hospital in 2008.

Their actual name is D & F Health Partnership Limited and Daly, while a founder, is no longer listed as director. He and founding/current Health Partnership director Deirdre Foley were also directors of Meret Healthcare, which was set up in 2007 “to build a network of primary healthcare centres across the country”. That is property speculation and rent seeking to me and you.

Meret Healthcare is a new, dynamic Irish company, providing specialist property services, and much more, to the primary health care sector in Ireland.

Drawing on a wealth of expertise and international experience, Meret intends to build a network of primary healthcare centres across the country, in partnership with established General Practitioners.

The centres will provide opportunities for the Health Service Executive to establish primary care teams, to bring new services to local communities, and to make health policy happen.

We believe that each Primary Healthcare Centre will become a one stop shop for all primary care services in the community, and we encourage local healthcare providers to relocate to our centre.

If you are a General Practitioner, Chiropodist, Dentist, Dietician, Occupational Therapist, Optometrist, Pharmacist, Physiotherapist or Podiatrist, we can supply you with modern practice facilities, and give you the opportunity to work with other clinicians.

But wait, there’s more.

They are also joint directors two entities, something called North West Healthcare Development Company Limited and another, North West Healthcare Investment Company.

Health Partnership also made a submission to the Dept of Finance on ‘tax exemption and high earners’ in 2005

Mr Daly departed both Health Partnership and Meret Healthcare in April 2012. Two months before he was appointed to the role of Chair the Galway Roscommon University Hospital Group by James Reilly.

The term of the appointments is for three years and the boards of the groups will be established initially on a non-statutory basis.

The two new hospital group Chairmen, working in consultation with the Chair of the Strategic Board, will have key roles in the development of effective corporate and clinical governance structures for the groups along with the quality and safety of systems of care in place for patients of the hospital groups. Central to this will be overseeing the implementation of the relevant recommendations of the HIQA report in relation to Tallaght Hospital.

The Minister identified a number of key responsibilities for the Chairmen including:-

• Ensuring compliance with the Code of Practice for Governance of State Bodies,

• Undertaking an assessment of the composition, competency profile and potential conflicts of interest of potential board members and making the necessary changes required to ensure that the board is constituted appropriately and in accordance with modern day corporate governance of boards,

• Mandatory board induction programme for new board members and mandatory on-going development programme for board members which the Department will address this at a national level,

• Clear definition of the role and function of the board;,

• Oversight of the building of strategic partnerships with other key stakeholders so that the organisation does not operate in isolation of the national and local system for delivery of care and support to its population, ensuring that a clear scheme of delegation of accountability from the board to the Chief Executive and executive directors is designed, taking account of the interim accountability arrangements put in place by the HSE to manage the transition towards the establishment of the independent, competing Trusts planned as part of the programme for government,

• Ensuring that there are annually agreed objectives in place for the Chief Executive that accurately reflects the realm of their accountability, responsibility, and authority.

The Minister believes it is essential that the business of the board is conducted in an open and transparent manner with the maximum amount of its meetings held in public by June 2013 including an Annual General Meeting in public from 2013. He has also instructed that a self-evaluation of the board should be carried out and arrangements should be in place to facilitate staff to raise concerns about the quality and safety of patient care and for consideration of information provided by external sources, including patient advocates, in relation to the delivery of safe care to patients.

Speaking of the appointments, the Minister said “the leadership skills, knowledge and experience these three gentlemen bring to these important roles will be invaluable. I wish them well in these important roles and assure them of my support. They will be supported and overseen in their endeavours by the Special Delivery Unit in my Department”

 

Ó Clochartaigh yesterday said that Reilly mentioned “issues surrounding the procurement of the report”.

Here is what the minister said

The review of maternity services undertaken by the west-north west hospitals group included the maternity units at Portiuncula Hospital Ballinasloe, Mayo General Hospital, University Hospital Galway, Sligo Regional Hospital and Letterkenny General Hospital. While the draft report presents various options for service reconfiguration, I understand the report does not recommend any option in particular.

I am aware that an issue has arisen, however, concerning the commissioning of the review of maternity services on behalf of west-northwest hospitals group. At the request of the director general, the HSE internal audit unit has undertaken a review and established that the procurement of services was not in accordance with HSE national financial regulations.

I further understand that the director general has written to both the hospitals group chairperson and the chief executive officer outlining his concerns, seeking to ensure the recommendations of the audit unit are implemented and that there will be no further breaches of procurement rules. I am satisfied this operational matter is being dealt with appropriately by the HSE working with the chief executive officer and the group board and that any issues will be resolved in that context.

So..

1) The west-worthwest hospitals group  (Galway, Letterkenny, Mayo, Merlin Park, Portiuncla, Roscommon, Sligo) appear to have procured services in a way “which was not in accordance HSE national financial regulations”.

2) The services were provided by a company called Health Partnership, a company founded by the ministerially appointed chair of the west-northwest hospitals group.

3) According to Ó Clochartaigh, the report will result in the closure of maternity centres in Portiuncula Hospital at Ballinasloe, Letterkenny, and possible downgrading of other services in the group.

4) The ministerially appointed chair of the west-northwest hospitals group is also deeply involved in the development of private healthcare clinics, primary care centres and the property that is at the very heart of so much of it.

Dr.FIVE  30 May 2014