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Friday 22 September 2023 Dublin: 8°C HSE boss Paul Reid said he would be stepping down at the end of the year.
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'Remuneration is significant': No appetite in Govt to increase €420k salary for next HSE boss
Questions have been raised about whether tensions between the HSE and Department of Health played a part in Paul Reid’s decision to step down.

THERE IS NO appetite in Government to increase the salary for the next boss of the HSE, with the Taoiseach stating that the “remuneration is significant” already.

Paul Reid confirmed this morning that he will step down from his position later this year.

In a statement, the health service said Reid had agreed with the chairman that he will step down in December 2022, facilitating a period to advance the process of selecting a successor. He said today that he has no immediate career plan.

Reid was appointed in 2019 by then health minister Simon Harris and was due to hold the position for five years. 

The Taoiseach confirmed that he spoke to Reid this morning. Micheál Martin said Reid said his departure is for personal reasons and that he is not taking up another job elsewhere. 

Questions have already turned as to who might replace Reid and what they might get paid. 

The Government faced difficulties in finding a replacement for the former HSE boss Tony O’Brien, who was on a salary of around €250,000 annually.

Reid was hired on a salary of €370,136. With allowances of around €50,000, his total pay and pension package increased to €420,103 last year

Reid and the top 10 best paid non-medical staff in the HSE — mainly managers — last year shared an aggregate €2 million in pay.


Speaking to reporters today, the Taoiseach said the “remuneration is significant”, adding that it is a “very demanding job” with huge pressures attached to it. 

Martin said it is important that the Government “proceed properly” and “take time to recruit a top class replacement for Paul [Reid]“.

“I think Paul brought great additionality and additional value to the HSE in terms of organisation and in terms of driving forward a whole range of reforms, which don’t often get the same limelight or attention,” he said.

“It is certainly challenging position,” he added, stating that it can be difficult for a person “because people keep talking about the salary that the person gets”. 

“Having been a former minister health myself, health it is one of the most difficult areas in terms of administration, given its enormity, its complexity, and there are so many different groups and agencies, disciplines to be accommodated in terms of policy development,” he said.

Pay packet

Two senior senior sources have indicated that the Government was unlikely to loosen the purse strings to increase the salary if there were problems again in recruiting a successor. 

One stated that it is already a very good salary to be paid, with the other stating that ”given the current climate” they doubt any pay increase would be acceptable to the public. 

However, it was acknowledged that Reid is not leaving until the end of the year, and things could change, highlighting that it was hard to fill the position before Reid was identified.

“Let’s see what happens over the next few months,” they said. 

Those in Government circles are happy that Reid has given plenty of notice, which means there will be no scramble to find a replacement. 

Replacing Reid with a “CEO type” is the preference, with there being somewhat of an aversion to replacing the HSE boss with an NGO worker or manager. 

Having a woman take over the job is also seen as an attractive prospect, someone that can bring a fresh take to women’s health in Ireland, it is understood. 


Those in Government circles did express their shock at the announcement today, with multiple politicians describing the timing as “strange”.

The Taoiseach confirmed that he only found out the news today and spoke to Reid this morning, prior to him making the announcement public. 

Questions are being asked about what happened between yesterday and this morning, when Reid appeared on RTÉ’s This Week programme, where he said he planned to go ahead with the closure of the ED in Our Lady’s Hospital in Navan, Co Meath. 

Donnelly, as well as a number of other ministers, have said that Government has not taken a decision to downgrade the ED.

The Taoiseach batted away suggestions today that there were tensions between Donnelly and Reid over the Navan Hospital emergency unit controversy and that this was a tipping point for the exit of the HSE boss. 

Reporters questioned the Taoiseach today on whether during his conversation with Reid this morning, was the case of Navan Hospital or tensions between Reid and the health minister and the Secretary General Robert Watt raised at all. 

“Not at all, no,” Martin quickly replied.

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Reid took to the radio yesterday to state that the emergency department in Navan Hospital would be converted into a 24-hour medical assessment unit.

Patients attending this new unit would need a GP referral and critically ill patients would be diverted away from Navan to other hospitals such as Our Lady of Lourdes in Drogheda.

Concerns have also been raised that NEDOC – which operates a after-hours GP service from 6pm to 8am is due to be curtailed in August, only opening until 10.30pm each evening. 

Such a curtailment would result in no GP referrals being made to the 24-hour MAU after the hours of 10.30pm.

The HSE plan for the ED has been criticised by clinicians and several politicians, including the Minister for Health, who said he was not satisfied with the plan and had instructed the HSE not to proceed.

Navan decision

Speaking to RTÉ’s This Week yesterday, Reid said the HSE was pressing ahead with the plan despite the minister’s instruction.

He acknowledged the minister’s concerns and said they will be addressed over the coming weeks, but “ultimately we have to do this” because of patient safety.

“People in the Navan and Meath area are really at risk of poorer health outcomes and indeed death if we don’t address these actions,” he said.

Reid stepping down comes amid what is being dubbed a “mass exodus” of people from the top jobs in health. 

Chief Medical Officer Dr Tony Holohan and his deputy Dr Ronan Glynn have both resigned in addition to Anne O’Connor, the chief operating officer of the HSE, who has left for a job with the private health insurance company, VHI.

Those in Government are concerned about the “brain drain” in the Irish health service.

“There is a lot of turnover for sure,” said one source, adding that it is an employees market right now. They can get paid good money and get a lot less abuse, they added. 

While the controversy over Navan Hospital is being pointed to as a tipping point for Reid, some are putting it down to Reid being “burnt out” stating that he has become increasingly frustrated with criticism of his salary and tone of some of the more “tetchy” recent Oireachtas Committee meetings.

In March, Reid asked Independent TD Verona Murphy for a “level of respect” after several rows in at a hearing of the Oireachtas Public Accounts Committee.

Murphy had been asking HSE officials questions on children’s mental health services in her constituency and said she was frustrated with the lack of answers. 

“This is an absolute farce today that you’ve decided not to come in here and to be eyeballed to be answered these questions and you’re avoiding most of them,” said Murphy. 

Reid responded, stating: “We are coming into this committee as we do to all committees as professional public servants with full respect for parliamentarians, the role of Deputies, the role of Senators.”

Another source said Reid “couldn’t take it anymore”. 

It is no secret that there has been tension between the Department of Health and the HSE for some time, but some of said it is a “healthy” tension between two bodies.

“That tension has been there for years, so I can’t see that being a reason,” said one source. 

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