I thank the Chairman and committee members for the invitation to attend today in my first full week as the chairperson of the new board of the Health Service Executive, HSE. I am joined by Mr. Jim O’Sullivan, who has been appointed as secretary to the board.
The Minister for Health signed the commencement order for the Health Service Executive (Governance) Act 2019 last week and attended the first meeting of the new board on Friday. The establishment of an independent board to oversee the HSE is a really important step in improving the governance of the health service. It is also one of the key recommendations of the Sláintecare report, which is the first of two reasons I am privileged to be here today. I and my fellow board members will make as good a contribution as we possibly can to achieve the committee’s expectations as expressed in the report. As one reads the Sláintecare report, one gets more and more excited and impressed. The plan and the cross-party support for it was a large part of why I went for the role.
The committee’s invitation referred to gaining an insight into my experience and vision for the role on this, the most important State board. I was educated, as Gaeilge, in Coláiste Mhuire in Parnell Square, Dublin, and as a chemical engineer at UCD. My work experience to date has largely been in the UK with some time in the US and continental Europe. My early career was in the chemical and life sciences industry, followed by time in management consulting where most of what I did was run complex change programmes in large multinational companies. I have been chief executive of the British Council since 2015. I have focused on aligning the British Council behind key themes important to the UK in education and culture, as well as strengthening the organisation’s capacity and capability across its network of offices in 115 countries.
It is probably the bit in the middle which is more obviously aligned with the HSE. From 2007, I was chief executive of Macmillan Cancer Support where I helped the organisation reshape cancer services across the four nations of the UK, both on its own and in collaboration with other organisations, leading to Macmillan being perceived consistently as the public’s most respected charity in the UK. Some of what we did was about new care models, the use of data to measure and improve outcomes, while other aspects were around focusing on patient experience.
In terms of governance, I have held non-executive roles on the boards of a range of organisations from small local charities to the board of NHS England, which commissions healthcare for the population of England. There are differences, as well as similarities, between the HSE and NHS England. Both, however, are the organisations and boards with the ultimate accountability for spending taxpayers’ money to deliver the best possible healthcare for the available money for the population of the jurisdiction.
I believe my experience to date puts me in a good position to lead the board of the HSE on its transformational journey as set out in Sláintecare, while holding the HSE to account for delivering the current plan. In doing so, we must have the credibility to make the changes needed to have a health service that will continue to serve the public into the future.
The board had its first formal meeting on Friday, but we had got together informally several times previously. I am pleased with the calibre of those the Minister has appointed to the board of the HSE. Like myself, and indeed all those who believe in public service and the public health service, we are united in having a driving ambition to ensure Ireland has a world-class health system of which we can be proud. The board currently comprises ten other members, with an additional member to be appointed by the Minister presently. We are varied and have different competencies, including clinical and governance expertise, patient advocacy, change management and financial management. My role is to bring this together into one properly functioning board, holding people to account while, at the same time, driving strategic direction. I am pleased with the appointment of Mr. Paul Reid as chief executive officer. I look forward to working with him and his executive colleagues on this shared ambition.
The cross-party political support that underpinned the development of Sláintecare gives us a great and once-in-a-generation opportunity to build a forward-looking health service. The board must exploit the momentum for change in the best possible way. We must ensure we have the right systems and controls in place to ensure the financial stability and predictability of the HSE. The board must support the executive to ensure we create public confidence in the HSE’s financial management, which will then allow us to seek further investment for the implementation of other aspects of Sláintecare.
I have had a chance to discuss our short-term and long-term priorities with board members, officials and Ministers. The key priorities are developing and implementing an effective performance management and accountability system in the HSE; building public trust and confidence in the HSE and the wider health service; ensuring the HSE’s full support for and implementation of the Government’s programme of healthcare reform, as set out in the Sláintecare implementation plan; and supporting the leadership and staff of the HSE to continue to improve health outcomes of the public, as well as retaining them.
There is a great deal to be proud of in our health services, in particular the significant progress made on outcomes such as increased life expectancy. Since 1990, life expectancy in Ireland has increased by almost seven years. In an average year, the life expectancy of our population typically goes up three months. In a typical day, it goes up six hours. On average, since 1990, every day of every year has seen life expectancy of the average citizen go up by three months per year. This is truly astonishing and one of the fastest rates of improvement in developed economies. There is more to be done, however.
On behalf of the board, we are looking forward to working with the wide range of stakeholders, including the committee, to do the job recommended in Sláintecare, which is expected of us.