An efficiency audit prepared as part of the Government's health strategy has commented on the "vested interests" preventing change.
The audit said that there were too many vested local interests, which prevent change and prohibit the delivery of value for money in the country's health boards.
The consultants who did a detailed examination of the health service said that it was concerned that there are insufficient people with the ability to manage change and implement change within the system.
It says that local politics should not be allowed to get in the way of good rational planning. It also said that the consultants contract is flawed, especially in terms of managing the input of their time to the health service.
The Deloitte and Touche team of consultants examined the administrative structures of the health service, the department, health boards and organisations in an audit of the health service for value for money.
It is understood the department intends to publish the report in the near future. It said that the political nature of health boards constrains the delivery of the best value for money health services, and can adversely affect decision-making within the regions.
It suggests there is a requirement for smaller, tighter boards and a need to ensure that the focus of local political input is on a representation basis and not a decision-making basis.
It said that most of the current managers have grown up within the system, where the focus is much more on administration than the management of service delivery.
Whilst their dedication to the service is unquestioned, the report said that this environment creates difficulties in terms of skills and limits new thinking.
The capability of managers to change from the relatively recent environment where resources were constrained to one where considerable funding is now available has proven to be a major challenge to the culture ingrained in the Irish health system, the consultants said.
It said that the boards also suffer from a lack of resources in areas such as strategic planning, health economics, monitoring and evaluation and aspects of Information Technology and finance.
It said that the consultants contract, which is now up for negotiation, is flawed in terms of managing the time input of consultants and in managing the public private mix in hospitals.
View the health strategy in full at the Health Department site.
To view the audit by Deloitte and Touche, click here.
