Building a Better Health Service


Why start a social movement for change in the health services?

masterclass values in action


Challenging Times

While I’m at risk of stating the obvious, let’s be clear on where this begins; Ireland has had an incredibly challenging decade as a result of the economic crisis. This has impacted us personally, professionally, and as a society. It has left our health service under resourced and under pressure.


It should come as no surprise that health service staff have not been immune to the impact of the last decade. Our staff have been, and in many cases remain, under enormous pressure. A sense of disconnect with management, along with feelings of being under pressure and being under appreciated, all come through consistently in our staff surveys.



The public narrative around health during this time has been predominately negative – the media and political system has, at times, been relentless in its criticism and the health service comes in for particular focus. Media narratives don’t often have space for the people who did their best despite the challenges they faced, for staff going the extra mile for patients, or the great efforts made to solve a complex problem. The, sometimes disproportionate, focus on the negative aspects of our health service has, naturally, impacted staff working in the system. It has tested our resolve, damaged our confidence, and diminished our sense of pride in what we do.



At times the stress we have all been under has been visible to our colleagues and to patients. If we are being honest; our behaviour has not always been exemplary during these challenging times. Not wanting to single out any one example, as there are many; but one that is particularly well known is the tragic events that led to the HIQA Investigation into the Midlands Regional Hospital, Portlaoise. In examining how the families affected found dealing with the health service in the aftermath of their loss, the report identified that significant changes in culture in the health service were needed to “orientate the culture towards the inherent qualities of compassion and openness in the care of patients and families” in order to deliver a far better experience to patients and their families.



If we step back and look afresh and what brought us all to work in the health service in the first place; it is typically because we wanted to make a difference to people’s lives. We wanted to help.



It is time to reconnect with this common purpose and to work together to rebuild trust and confidence in the health system and to develop a sense of pride in working for the health service again. We must do this in a way that supports and enables the reform needed to ensure our health service can meet the needs of our citizens now and in the future. 



There is much more I could say about where we’ve come from and the many challenges we face in adapting our health service to suit the times we live in but, in essence, it boils down to two things; we need to find ways to ‘bounce back’ from the last decade and we need to empower staff to change our health system from the inside out, if we are to build a health service we can all be proud of.


This is why Values in Action was born


Values in Action is about creating a culture in our health service where staff feel valued and empowered; which evidence shows leads to improved outcomes for patients. The SlainteCare report, by the All-Party Oireachtas Committee, has identified culture as a key enabler for reform in the health system.



Values in Action helps to create more positive workplaces for our staff which supports staff retention and recruitment; a significant challenge for us now and into the future. Importantly, it’s also about giving patients and service users a positive experience when they come into contact with our health service. Values in Action is mobilising people and empowering them to lead the changes that we need to truly build a better health service. As one of our Values in Action champions in the Mid West put it; 


it’s for ourselves and it’s for the patients.


This is not something we have done before. It’s a new approach to building the kind of health service we all want - from the inside out.  And it’s going to take all of us - from all grades, roles, disciplines and backgrounds - working together to change our health service for the better. Let’s improve the experiences of those who use, and of those who work in, our health services.



Values in Action has been underway in the Mid-West in the UL Hospital Group and in Mid West Community Healthcare since mid-2016 and is already showing very promising results. With the support of the Director General, Tony O’Brien, the HSE has recently established a small team to bring this innovative approach to other parts of the organisation.



This team and I are partnering with various parts of the health service to roll-out Values in Action across our health services. We’ll share our progress, and the challenges we will no doubt face, here from time to time. In the meantime get in touch if you’d like to be a part of this movement. You can also follow us on @HSEValues on Twitter to keep up to date with our progress.



Kirsten Connolly
Initiator of Values in Action
October 2017