Shooting from the hip

Gary Culliton talks about the problems of Ireland’s HSE with the Irish-born troubleshooter and presenter of BBC’s ‘Can Gerry Robinson fix the NHS?’
It doesn’t matter what you pay a Chief Executive, if you get an organisation that works,” according to Irish-born troubleshooter businessman, Sir Gerry Robinson, the ex-Chairman/Chief Executive of Granada and Sky TV. “It is lost in the roundings; it’s irrelevant.”
Sir Gerry, who presented the three-part BBC series ‘Can Gerry Robinson Fix the NHS?’ believes that Prof. Brendan Drumm is clearly not the right person to be running the health service: “To expect a guy like that, who has never run anything of substance in the past, to run the biggest organisation in the country with the biggest budget and the biggest number of external interfaces and to do it well! It is not a good plan.”
Staff are not going to “buy into” the Chief Executive if he is an administrator, Sir Gerry argues. “These are bright, highly-trained people and the person trying to run them is an ex-administrator within the health service, who really thinks he has to watch the budget day-in, day-out.”

The corporate guru believes the knowledge needed to sort out the HSE is already there within the organisation. “If the people who are in the HSE don’t know how to run it now, who does? A huge sum of money, nearly €15 billion, is involved for a population of four million,” he said.
With long experience as a corporate fixer, Sir Gerry, who has a home in Raphoe, County Donegal, says the first thing you look for in seeking a takeover target which is not well run, is whether it has had in the consultants.
“The HSE, which has recently hired McKinsey & Co., has bought this argument that you bring in experts from outside, who then talk to everybody internally and find out what needs to be done. But if you are going to separate the health service from government, the key thing is to have the most effective person in the country in charge. The structure doesn’t matter a damn if you haven’t got the right people running it.”
h4. First-class manager
The ‘right person at the top’, who would require a salary of up to €2 million annually, would make sure he had four or five exceptional people as Regional Directors, with a number of hospitals reporting to them, Sir Gerry said. “They would make sure they recruited a first-class manager to run each of those hospitals. Each month, there would be a review of what the issues are, what’s needed to be done, funding, holdups and individual specialities’ concerns. All of that is do-able,” Sir Gerry said.
Management is about enabling people to do what they really want to anyway, the businessman believes. “Medical people are not trying to make things difficult or impossible. They just want to go ahead and do the job. They are up for it,” he said.
Ireland retains ministerial involvement in the running of our health service, Sir Gerry said. “Politicians’ means of measurement is totally different. It’s short-term, it’s about telling it better than it is. In fact, running the health service properly is not about a series of exciting new initiatives. It’s much more mundane, making sure the system works on a day-to-day basis. If something doesn’t work, you follow it up: you cure it,” he said.
The objectives (political and corporate) could not be more different, Sir Gerry argues. “You do a great deal of harm by making short-term changes rather than letting the organisation get on with things,” he said.
“The thing that struck me from going into a number of hospitals was not how difficult it is, but how easy it is,” Sir Gerry argued. Rotherham General was the hospital picked for the BBC TV series ‘Can Gerry Robinson fix the NHS?’. “We just did some very basic things. We didn’t spend any money. With very little effort, that hospital now has the lowest waiting lists in and around its area in Yorkshire, by far. It’s depressing in some ways how simple some of this stuff is,” he said. Sir Gerry has also been looking at the Belfast Trust hospitals, the Royal, the Mater and others, for an upcoming TV series.
Without question, you need the right man at the top, he contends. “It’s a huge logistical exercise, which you break down into its parts and you make sure you have the right person running each of the parts. You’re not going to solve all the problems straight away, but I promise you, six months down the road, you’d see quite dramatic changes. You need to get someone like Terry Leahy, who runs Tesco, to run the HSE,” he said.
Management should not even try to manage the healthcare side of things, Sir Gerry argued: “The key thing is to work out what is necessary to keep the medics working diligently day-in, day-out, doing what they do best and actually what they want to do anyway.
“Let them take care of the medical side of things. Sometimes you will get caught out working in this fashion. But as things stand currently, when you go into most hospitals, it feels like they’re caught out all the time.”
h4. Good hospitals
“The depressing thing is that there are lots of examples of healthcare situations which work,” Sir Gerry said. “There are any number of good hospitals which operate really well, which have good people running them and which have low waiting lists.”
However, that does not seem to spread across the rest of the organisation somehow and there is no real central control over what happens in the health service, he concluded.