In 2018, when Martin Curley was appointed as director of digital transformation and open innovation at the HSE, the then health minister, Simon Harris, was effusive in his welcome. “A key appointment in the context of developing our eHealth infrastructure and supporting health reform,” the minister said.

The words were not without merit. Curley’s resume was, and remains, seriously impressive. After all, he was a university professor who had also thrived at the top tier of multinational giants.

Prior to joining the HSE (a move that meant a massive pay cut), Curley was a senior vice president with Mastercard. Before that, he was vice president of the chip giant Intel where his role expanded to become a senior principal engineer and director of Intel Labs.

Quite frankly, he was the sort of person who we want to join the public service: qualified, capable, and willing to take a pay cut to work for the greater good.

Last week, however, he resigned.

He was in the job less than four years, but the former multinational executive had simply had enough of the public sector.

He announced his resignation on LinkedIn on Sunday citing difficulties in implementing his vision. He also compared the task to scaling Mount Everest in bad weather.

“We have called off this particular ascent on Everest. Bad weather prognosis and supply chain and funding blockages. We could still succeed but there would be too many casualties, including me,” Curley wrote.

“Therefore as part of a well thought out, broader and evolving plan I resigned yesterday with immediate effect from the Health Service Executive.”

Days before he resigned, Curley came to the offices of The Currency to meet our journalist Rosanna Cooney for his resignation interview. We agreed to hold off on publishing the interview until he announced his resignation.

He was articulate and outlined, in some depth, where he felt the health service was failing. Given the amount of money we spend on the health service, his views were sobering.

“I think most of the problems in the HSE are management problems. We have this kind of dogma, of this is the way we do it, and that needs to change,” Curley said.

Curley also claimed that frustrating healthcare in this country is a lack of “basic competence” and “no accountability” within elements of the HSE management.

“It’s just this massive inertia, and it’s present in every health system. But I think Ireland is particularly bad, this is such an outlier. Medicine is an industry that is resistant to change, so it isn’t exclusive to Ireland, but it does seem extreme here,” he said.

Curley blamed the number of blockages to projects he was trying to implement at scale on a lack of motivation to innovate. “I think this is a really complex, really unwieldy system, with lots of barriers,” he said.

Speaking to RTÉ following his resignation, Curley said he was “absolutely horrified” by the recent overcrowding in Irish hospitals, adding that technologies are available to assist in this regard.

When asked if the HSE was fit for purpose, he said: “To be very honest, no it’s not. But the problem is bigger than the HSE. There are many amazing people in the HSE, but there are many people, like me, who are deeply frustrated.”

Curley was not the first outsider to join the public sector from the private sector. After Ireland’s economic collapse more than a decade ago, one of the key reform items was bringing more outsiders in. However, in truth, most have left, most of them unable or unwilling to put into the status quo.

However, given the vast sums that Ireland pumps into its underperforming health service each year, Curley’s comments are worth interrogating.

After Curley’s departure, Stephen Mulvany, the interim chief executive of the HSE, said: “There’s two sides to every story”.

Last week, when asked by Martin Conway, the Fine Gael senator, to comment on the issues Curley had raised in his resignation, Mulvany said that he had not seen the details.

“But look, like everything deputy, I’ll leave it at this, there’s two sides to every story as you know. So I’m sure that the full story will be told in due course. We prefer not to comment on individual members of staff. We obviously wish Martin well,” Mulvany said.

Despite this, Curley’s comments raise issues about the ability, willingness, and capacity of the HSE to deliver change. Money is not the issue.

As Michael McGrath, then minister for public expenditure, put it in the most recent budget:

“Budget 2023 continues this very high level of investment in our public health system by providing for a total allocation of €23.4 billion. This provides for a €1.15 billion increase in core current funding, a 2023 Covid allocation of €757 million, and an additional €117 million as part of agreed NDP allocations for the delivery of additional health infrastructure.”

So the money is there. The issue is how it is being spent. Back in 2015, Susan Mitchell went inside the HSE for a number of months to understand how it worked. She worked with me at the time in the Business Post, and is now a policy advisor to the Minister for Health Stephen Donnelly. As part of her role, she spoke extensively to the then-CEO of the HSE Tony O’Brien. His views on the status of health policy were summed up in the following words: no money, no policy, no vision.

Close to a decade later, it seems nothing has changed. We want better outcomes. We are prepared to pay for them. So just what is going wrong?

*****

Meanwhile, we had a large number of stories on the site last week about aviation. This was hardly surprising given a string of international aviation conferences were held in Dublin.

Having navigated a pandemic, the aviation sector now faces inflation, interest rates, and an invasion. Yet KPMG’s head of aviation finance Joe O’Mara remains upbeat and explained to Tom how Ireland can stay at the centre of the aviation world.

Aengus Kelly, the CEO of aviation leasing giant AerCap, talked to Sean about mega-deals, secular demand for lessors, and the impact of changing interest rates on his bottom line.

Meanwhile, from its HQ in north Dublin, ASL Aviation Holdings now owns or part-owns seven airlines around the world and is a global leader in freight transport. But, as its CFO Mark O’Kelly explained to Tom, this is just the start, and the company has big plans for the future.

In other news, while Ireland is well used to institutional investors purchasing entire apartment blocks, there has been little history here of American-style corporate landlords aggressively competing in the open market to assemble portfolios from once-off home purchases. Until now, as Thomas reported last week in a joint investigation with the Dublin Inquirer.

Should developers get tax breaks? Not according to Stephen Kinsella, who argued last week that the economics of tax breaks for construction on both the demand and the supply side seem pretty terrible.

Many commentators and analysts suggested that the various strikes in the UK are a response to the cost-of-living issues that British consumers are facing. However, Peter Kinsella argued last week that what we are actually seeing are the first signs is a structural shift in labour markets.