Re: Health Service Administration

Dear Madam

Peter Boylan’s letter of Tuesday, February 22 echoes the feeling of many people including this correspondent who have worked in the health service and must deal with that Department on a regular basis. However, while focusing on “systemic maladministration” is important, the root cause of the problem is an insensitive management philosophy which relies on performance indicators, benchmarks and other business tools.

“Wasting time with people” is how health professionals who take time to care properly for their patients are made to feel in a health service dominated by that philosophy and pouring more resources into the system without reforming management thinking will not succeed. Only a philosophy of caring is appropriate and that means fundamentally both patients and frontline health care professionals are treated as people and time is allowed for better care in a holistic way.

“Ray” a fifty year old man who has been homeless for several years provided me with very practical evidence of this recently when he described what happened when he went in search of treatment: “They don’t see you now, they examine you on the computer and give you a piece of paper, then you leave.” If people have deep psychological problems and cannot cope when they seek help just processing them like an inanimate object will only ensure they drift from one service to another never getting help and costing the State even more money!

An even greater irony is that the current management philosophy which is supposed to help expose inefficiency has only served to help senior mangers cover up the failings in the system, and far from making life better for those in need in society it has actually created outsiders, as those who have sought to speak out have been made to feel excluded. This tendency is not exclusive to the health service, but is apparent across all of the social and homeless services as the same management philosophy is pervasive and must be replaced by a people centred philosophy of care or the current push for reform will not succeed.

Yours sincerely

Director & Co-Founder

PS. Ray is not his real name – changed to protect his right to privacy.