A WAR of words between outgoing HSE chief Cathal Magee and the Department of Health over policy decision has been revealed.
Mr Magee, who announced last month that he was resigning, warned that guidance was required from Health Minister James Reilly and his department on what action to take on cost overruns and big shortfalls in hospital budgets.
He wrote a number of letters to the department explaining the dire state of the health service's finances and the need for the minister to make policy decisions on cutbacks.
Mr Magee accused the department of failing to act as the financial problems of the health services became even worse.
He asked the department to explain to him how cutting back activity in the health services would tally with the demands to increase patient throughput to achieve targets on reducing waiting lists and the numbers of patients on trolleys.
In June, the secretary general of the department, Ambrose McLoughlin, of the department wrote back curtly: "I would remind you, as CEO, you have responsibility and accountability for delivering the national service plan as approved by the minister.
"In that regard, my view is that there are some areas which you need to attend to where further cost savings could be achieved."
Mr McLoughlin told him such areas for cost-cutting included overtime payments, sick leave, more flexible rosters, locum cover, cost-effective prescribing of medicines, and more redeployment of staff.
Contents of a number of letters between Mr Magee and the department were revealed in the Irish Times today.
A couple of weeks ago, Mr Magee met Taoiseach Enda Kenny about his decision to resign and he was not asked to reconsider his decision.
The meeting took place as the Health Service Executive issued warnings to the nation's public hospitals they must immediately begin axing all extra spending.
A new role of director general of the health services was being introduced by the Government and Health Minister Dr Reilly which was "very different" to the role of chief executive for which he had signed up, he said.
The HSE itself is also being replaced.
Mr Magee later admitted there were tensions in his relationship with Dr Reilly but stated that they were not the reason for his decision to leave.
He said he had a very business-like relationship with the health minister and their exchanges at times were very robust and very frank.
He said health policy was a matter for the minister, not the chief executive.
Mr Magee said his decision to forego a €1m compensation package was because such a payment to him would have been entirely inappropriate in the current economic environment.
Such funds would have had be taken from the health service's budget, he said.