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‘Top-heavy’ HSE to cut posts at Dublin headquarters

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A major reorganisation of top management in the health service is set to be unveiled shortly, as moves to transfer responsibility for many Health Service Executive (HSE) functions to the regions gather pace.

Key posts in the senior management executive of the HSE are being terminated as part of plans by chief executive Bernard Gloster to halve the number of top managers in the organisation.

While this is not expected to happen immediately, existing posts such as chief operating officer and chief strategy officer will no longer exist at HSE headquarters in Dublin.

The HSE has long been criticised for employing too many layers of senior managers, whose numbers have swollen in recent years. Mr Gloster, who has acknowledged the organisation is “top-heavy”, promised “the most significant delayering” of the organisation when he took up the CEO post last year.

Six regional executive officers, each responsible for public health services in their areas, were appointed in late 2023. Reporting directly to Mr Gloster, they will run the promised HSE Health Regions, which are due to start operating this month.

The six Health Regions are replacing six regional hospital groups (a seventh is Children’s Health Ireland) and nine community healthcare organisations.

While hoping to “shrink the centre”, Mr Gloster anticipates the regionalisation process will have a “net zero” impact on headcount in senior management.

Under the changes, the chief operating officer and national director of acute operations roles are moving to the regions. The current COO, Damien McCallion, is expected to transfer to another role.

Dean Sullivan, who was appointed chief strategy officer in 2017, is on leave at present.

Mary Day, who was interim national director of acute operations, has returned to her previous post as chief executive of St James’s Hospital in Dublin. Since January, the post has been occupied on an interim basis by Grace Rothwell, the former general manager of University Hospital Waterford who won praise for having no patients on trolleys for more than 1,000 days.

The post of chief technology and transfer officer is occupied on an interim basis by John Ward after the successful applicant for the permanent position withdrew after interview last year. The post, along with that of chief information security officer, was created following the disastrous cyberattack on HSE systems in 2021.

The handling of complaints in the health services, as well as parliamentary affairs, have been added as responsibilities to the role of national director of communications.

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