How to make an extra €41,000 from the HSE

What, exactly is a Clinical Director in the Irish Health system and what do they do? I’ve asked this question before in another HSE, so I can examine it in detail.

It’s an important question, now that Dr Susan Reilly has become one of the most important leaders in the health service as the chief executive of the Dublin and Midlands Hospital Group. She will be paid €219,993 for this task – along with the very very generous perks and pensions that come with the job.

But she will also continue to be paid her ‘allowance’ as a Clinical Director.

My understanding of what a Clinical Director does is that they lead a clinical team. The official job description says that “each clinical unit is headed by a Clinical Director, supported by Nurse and Business Managers or relevant equivalents and a range of senior clinical staff.”

It also states that “a Clinical Director will be a Consultant member of the relevant Clinical Directorate, appointed by the employing authority. Executive power, authority and accountability for planning and developing services for and controlling resources used, directly and indirectly by the Clinical Unit are delegated from the employer. Clinical Directors report to (in a voluntary hospital or agency) the Chief Executive; under the Health Service Executive: Hospital Manager, the Hospital Network Manager or the Assistant National Director, HSE PCCC Directorate.”

But Dr Reilly is now going to be a chief executive. Will she report to herself? I asked the HSE about this and they came back with the following:

“The Hospital Group CEOs have been appointed from within the Health Services therefore Dr Reilly will retain her current terms and conditions. She will continue to provide clinical expertise to the health services in her role as chairperson of the HSE Drugs Group, which she will retain.”

That’s all fair enough – she won’t really be a ‘Clinical Director’. But she will be paid an allowance for being one.

It’s also good to know that the work as chief executive of several hospitals won’t be so onerous that she has to give up her other position, but she is hardly going to be the ‘Clinical Director’ of a group that isn’t engaged in much clinical work per se.

It’s just another example of allowances and payments that are made within the health service which might originally have had a purpose, but are now used to bump up salaries whether the person does the job or not.

The chief executives of the other hospital groups are going to be paid €142,000 – no mean sum either – but they will not receive any more allowances for clinical care, presumably because they won’t be doing any. And it would seem to a layman like me, that even if they had the skills, they wouldn’t have the time. €142,000 is a lot of money for any job – well over three times the national average industrial wage. But €219,993 is a massive five times that national average industrial wage, and then the government wonders why health costs so much?

With patient care, the HSE is on a race to the bottom. With their management, they are racing to the top.

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