Minister for Health James Reilly is over his quota of ministerial advisers and without any specific expertise in his priority area of health reform – universal health insurance. Martin Connor, Reilly’s most senior special adviser, was appointed last June for six months and in December signed a three-year contract worth €480,000. He is paid €160,000 a year for a time commitment of just 80% and he spends ‘on average’ half of his time in California, as he is a research fellow in Stanford University, California.

Connor is the most senior adviser in the minister’s Special Delivery Unit, which James Reilly set up as his “hands-on” “nerve centre” and which he has charged with achieving his own targets of reducing waiting times for public patients for hospital treatment.

The Minister for Health's special adviser Martin Connor is paid €160,000 a year for 80% of his time. By Sara Burke.

Minister James Reilly’s much-heralded special adviser Martin Connor, who is the most senior health policy adviser in the Department of Health’s Special Delivery Unit, is also a research fellow in Stanford University, in the heart of the Silicon Valley in California. Connor’s position was announced last June, when he was initially appointed for six months. According to responses from the Department of Health on 16 February 2012, “On foot of a Government Decision the services of Dr Martin Connor were re-engaged on a contract for services basis on an all in fixed price of €480,000 (incl expenses). Dr Connor’s contract for service is for the period 04 December 2011 to 03 December 2014.” That means he is being paid €160,000 a year for three years. When appointed as special adviser, Martin Connor was also appointed to the HSE’s Interim Board.

Targets set by Minister James Reilly for reducing the number of people waiting on trolleys and wait times for hospital treatment are unambitious, but if achieved they may be reason for cautious optimism. By Sara Burke.

On Wednesday 25 January, Minister for Health James Reilly held a news conference to announce new targets on reducing the numbers of trolleys and wait times for hospital treatment. It was good news all round, and “cautious optimism” was the prevailing sentiment of the day. After a national forum of hospital managers, HSE and Department of Health people, new targets were announced for shorter wait times in Emergency Departments and for planned hospital treatment. These have been two of the Minister’s priority areas since he came into government less than a year ago.

Last week's rejection of the HSE's National Service Plan by Minister for Health James Reilly was nothing but a poor attempt to distance himself from cuts he will oversee. By Sara Burke.

Having received a hammering from the print media over the holiday period, Minister for Health James Reilly launched a media offensive on 5  January 2012, appearing on both RTÉ Radio’s Pat Kenny show and in interview with Fergal Bowers on the News at One. These media appearances seemed, to this observer at least, a combination of damage limitation and pure optics. The same day, Reilly rejected the HSE National Service Plan submitted to him on 24 December 2011.

The HSE Service Plan is the most important health service document published in any year. It is the contract between the government and the HSE about what type and volume of services will be provided in the year ahead within the budget allocated.

With the launch of a new resource for parents and teachers who deal with children suffering from attention deficit hyperactivity disorder (ADHD), John Holden looks at how the condition affects people untreated in later life.

The phrase “she’ll grow out of it” probably runs through many parents’ minds if their child shows signs of ADHD. However, just because you were in school 15-20 years ago, when it wasn’t being widely diagnosed, doesn’t mean it didn’t exist back then. While ADHD is something usually associated with children, left untreated it will remain a problem for sufferers in adulthood.

One child in 20 in Ireland suffers from the disorder (signs tend to become apparent between the ages of 4-7 years). Trying to put any kind of number on adult sufferers, however, is far more difficult.

On 14 September, Minister for Health James Reilly announced that he had received Cabinet approval to lift restrictions on GPs treating patients with medical cards. So will this make it easier for people to access GPs and drive down the high costs of GP visits?

Quite simply we don’t know yet, and will have to wait for the detail of the legislation will determine whether it will or not, but let’s look at its origins in the EU/IMF Programme for National Recovery. There it says that, “All restrictions on appropriately trained GPs who wish to hold General Medical Scheme (GMS) contracts will be abolished.” This sentence - on page 33 - is contained in the section on professional services, where it is acknowledged that the costs of many professional services have come down but in a few specific areas – legal, insurance and GPs – they have not. The Competition Authority has also called for measures to increase competitiveness in this sector.

The aim is to drive down the costs of GP care through more open competition between GPs, which in turn should make GPs more accessible. However, the rules of the market do not always apply to health or GP care; particularly in this context, where the vast majority of GPs’ income comes from their medical card patients. In other words, the majority of their income does not come from the private free market but from annually guaranteed public money.

A badly designed Nursing Homes Support Scheme means that 1,100 older people are now waiting for nursing home places. By Sara Burke.

HSE figures released last Thursday (1 September) reveal that 1,100 older people who are medically in need of a nursing home place and have been through a rigorous financial assessment are languishing on a waiting list for that bed. When the Nursing Homes Support Scheme (the so-called Fair Deal) was launched less than two years ago it was heralded as “accessible, affordable and anxiety free”. Obviously it is proving to be none of these - it is not accessible for those on the waiting list, it is not affordable for the State as it has run out of money, and it is not anxiety free for the older people and their families who wait for a nursing home bed. 

How has Dr James Reilly fared during his first term as Minister for Health? Sara Burke reviews.

The political season has ended and James Reilly's speech to the MacGill summer school was upbeat, but immense challenges face him now and when the autumn season begins. At the 28 July meeting of the newly formed HSE board, many hard facts were tabled for discussion.

Exactly three months before, the old HSE board members offered their resignations. These had been sought by Minister Reilly, so they went before they were fired.

The new board is made up of the most senior officials in the HSE and the Department of Health; its secretary general, Michael Scanlon; the Chief Medical Officer, Tony Hollohan; the HSE chief Cathal McGee, and other HSE national directors. They have been meeting every two weeks since forming in May. Some of the figures presented to them on 28 July give a very stark insight into where we are now and the challenges ahead.