Efficient management of business organisations requires clear lines of authority and responsibility.When managers issue orders,they expect them to be obeyed. In rare cases where employees fail to follow orders without very good reasons,managers usually give warning that disobedience will not be tolerated and punished with dismissal. (In the old days before elaborate employment protection legislation,dismissal could happen on the spot,even for long serving employees.)
Apparently,such management prerogatives to manage have been completely undermined by trade unions in many departments of the largest employer in the Irish state,the Health Service Executive,HSE. Its work practices resemble those a self indulgent workers co-op rather than an efficient modern organisation's,as shown by The Sunday Independent story A stark choice between pay and patients - Analysis, Opinion - Independent.ie To make changes for the austerity programme,
"First they have to hold "implementation talks" which have already resulted in spats between unions and management,although nurses in some areas are already being redeployed.Change is slow.In an interview with this newspaper a fortnight ago,Brian Gilroy,the HSE's director of estates,said it took three years to negotiate a new,more efficient system with the trade unions."
In most businesses,there would be little or no negotiation with unions and a new system could be implemented in weeks in some cases.
How can Ireland hope to have an efficient health service with unions engaging in prolonged bickering over changes considered routine in business? I predicted in a p.ie post a few years ago that the health service would collapse once the government became unable to throw billions at the HSE.
In my opinion,the only solution is urgently to adopt Fine Gael's proposal for a system like Holland's in which private hospitals are paid by private monopoly insurers heavily regulated by the government. HSE personnel could be moved over to the insurers without the need for redundancy payments. The money would follow the patient instead of being handed out at the discretion of bureaucrats. Monopoly insurers would be needed to ensure that high tech operating theatres and high tech services could be confined to centres of excellence.