HSE changes reporting line of Confidential Recipient despite opposition

The HSE has changed the reporting line of the Confidential Recipient despite the former post holder warning the board that this would damage the role’s “independence”.

Up to late 2022, the Confidential Recipient had a direct reporting line to the HSE CEO. However, the post now reports to the National Clinical Director of Quality and Patient Safety. According to the HSE, the Confidential Recipient acts as an “independent” advocate for adults with a disability and older persons receiving services in residential care, day services or any community service from the HSE and HSE-funded organisations. The role was created in 2014 after the Áras Attracta scandal.

“In the period 2014 to 2022 the Confidential Recipient reported to the CEO of the HSE,” an Executive spokesperson told the Medical Independent (MI). With the appointment of a new Confidential Recipient in late 2022, “it was decided
that this reporting relationship would change in line with service synergies.”

The spokesperson said the “confidentiality and independence” of the role is “respected and maintained”.  The Confidential Recipient will have access to the HSE’s safety and quality committee meetings “on an as needed basis and at a minimum once a year”. They will also “still have access” to the CEO “if and when the need arises”.

In September 2022 the then Confidential Recipient, Ms Leigh Gath, attended a HSE board meeting prior to stepping down from the role. According to minutes, a discussion took place on the “recommendation by the current CR [Confidential Recipient] to the board for their consideration in relation to the relocation of the reporting line of the CR from directly to the CEO to the National Clinical Director of Patient Safety be reconsidered to maintain independence of the role”.

“The board agreed and it was noted that the CR will continue to have access to the safety and quality committee.”

The HSE informed MI that the board had agreed with the change in reporting line.

Commenting last year on the independence of the role, Ms Gath told MI the then CEO Mr Paul Reid was the only person in the HSE to whom she was answerable, and Mr Reid “never” interfered with her work.

In November, the HSE announced the appointment of Ms Gráinne Cunningham-O’Brien as the new Confidential Recipient.