Matt Shanahan Questions 50% Pay Hike for Health Secretary
Matt Shanahan criticised the planned appointment of a new Secretary-General of the Department of Health and the proposed almost 50% salary increase, calling the decision reactionary and rushed. He urged strategic and structural reform of the Department and raised specific concerns about pensions, selection fairness and COVID-19 operational risks.
Appointment pay increase questioned
Matt Shanahan challenged the decision to award an almost 50% salary hike to the Secretary-General role, describing the move as reactionary and rushed. He noted the preferred candidate has led the Department of Public Expenditure and Reform and questioned fairness where the candidate already occupies the post, the interview panel process, and whether future pension entitlements on the higher salary had been discussed. He estimated the pay rise could create in excess of a €1 million liability to the State and suggested a contract role or opening the post to private sector health managers might have been alternatives.
Concerns about departmental dysfunction and reform
He argued the pay decision exposed deeper dysfunction within the Department of Health and pointed to examples including the Heretory Report's national cardiac care standard, a 14-year delay to fund a new mortuary at University Hospital Walford, and multi-year delays in delivering a cath lab at UHW. Referencing the creation of the Department of Public Expenditure and Reform during the banking crisis, he urged consideration of structural change such as separating hospital and acute care from social and family care responsibilities.
COVID-19 operational risks raised
Shanahan highlighted current high infection rates and the threat of new variants, and drew attention to specific operational risks. He warned about dependence on the UK for import of medical-grade oxygen and said he had written to the Department on the matter. He also asked for clarity on a panel of up to 2,000 additional vaccinators, when they will be trained and deployed, and referenced a 30-hour requirement associated with the Pfizer vaccine.
Accountability steps and wider consequences
The deputy said other cabinet members were not made aware of the proposed additional salary and warned the move could create pressure for further pay acts across the public service while many private businesses struggle. He reported he has written to the Comptroller and Auditor-General and to the Public Accounts Committee requesting review, and urged that government leadership plan strategically rather than react to crisis points.
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Ministers, for many months now, at varying stages of the coronavirus epidemic, Government, the Health Department and the HSE are being continually asked what is the plan. It is fair to say that often it appears the master plan is hidden and the perception may be that Government health policy and leadership have been reacting to events. One such recent decision that could be so described is the announced pending appointment of a new Secretary-General of the Department of Health. The decision to award an almost 50% salary hike to this position appears to me to be both reactionary and rushed. A Government backbencher told me the reason for the decision was that the Department of Health Management was, as they put it, dysfunctional. I have sympathy for this narrative, having seen it first hand. The Department of Health's influence, for instance, in the development of a national cardiac care standard in the Heretory Report. A clinical standard that exists nowhere else in the world. A standard that describes travel time periods between two hospital centres for the treatment of emergency coronary blockage. This is a meaningless clinical measurement. Effective coronary unblocking treatment depends directly on the time envelope between symptoms onset and arrival into a cardiac catheterisation suite. Or I could refer to the funding approval delayed by the Department of Health for 14 years for a new mortuary build at University Hospital Walford, which was only secured because of a journalistic endeavour which highlighted corpses decaying in the unit because of a lack of refrigerant space and capacity. Or let's not mention the four-year calendar schedule that is elapsing to deliver a build tender award to a new cat lab at UHW. So, indeed, I can believe that departmental dysfunction may be real, but in that case, rather than just change in personnel, does it not indicate a need for a real strategic and structural change in the Department? During the banking crisis, it was recognised that the scale, complexity and oversight of the Department of Finance had become too large to be managed by the existing civil service structure. So, a new department was created, the Department of Public Expenditure and Reform. Given the significant scale and wide remit of the Department of Health today, surely now is the opportunity to look at strategic restructuring and consideration of separation of responsibilities, for example, such as the hospital and acute care sector from the social and family care services. What about reform within the HSE structure and its remit? Instead of any strategic review of our health governance, it appears government have taken the decision to react again by deciding that an overwrought position can be solved by a new appointment and a 50 per cent pay hike. It is ironic also, Ministers, that the preferred candidate for the position has been leading the Department of Public Expenditure and Reform for many years, and one presumes has supported the policy to oppose increased appointments and pay increases across medical, nursing and allied grades during the COVID crisis. Thus, does this ambition extend to the civil service structure? Also, one might ask. As a COVID response strategy, there are a number of other aspects to this appointment that require clarification, in my opinion. What evaluation had taken place on the need to provide a 50 per cent pay rise to the existing SecGen position salary scale? The appointment decision appears to favour a possible panel interview, yet how can that be the case for a fair interview process when the candidate is holding the position on offer, converting significant advantage in finance selection? What discussions, if any, were had regarding the waiving of future pension entitlements on the additional salary proposed, considering this position attracts the top-level civil service pension plan? The pay rise by my calculations, and I stand to be corrected on this, I believe to be in excess of €1 million liability to the State. Was any discussion had in terms of the candidate agreeing to waive the benefits of this salary increase in terms of pension roll-up, I wonder? If not, given the total employment costs involved, would such a move not have been that government should have considered creating a contract role, and possibly allowing private sector health management professionals to apply? It appears also that other cabinet members were not made aware of the additional salary increases to be offered, and neither was cognizance given to the pressure that this will cause in promoting further pay acts across civil and public service, at a time, I might add, when so many private businesses and employees are facing potential ruin. My personal disquiet on this issue has led me to write to the Comptroller and Auditor-General and to the Public Accounts Committee to have this matter reviewed. I believe at a time when COVID mitigation strategy forces hard-pressed taxpaying businesses and individuals to close down and depend on State subsistence, which for many is completely inadequate to cover their needs. Government leadership should be seen not to be reacting to individual crisis points, nor creating inflationary precedence, but rather should be strategically planning based on known deficits that can be overcome. Regarding our high present infection rates in Ireland and COVID-19, which continue to rise, and potentially may rise further given the fact of new variant, I would also point to the Department the risks around oxygen supply, and highlight that we are dependent on the UK for import of medical grade oxygen. I have written to the Department on this. I would also ask the Minister at some point to clarify what is happening with the vaccinators. I believe we have a panel of up to 2,000 additional vaccinators made up of community medics, nurses and retired healthcare people. Will they be trained and when? The Pfizer vaccine, it seems, requires 30 hours of online training, and surely if that is the case, have these vaccinisers begun to start this process yet? There is no doubt that we are now in the throes of a third and probably the most significant wave of COVID, and we do need every single hand at the pump. Thank you. Thank you. Thank you.
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