Senior HSE management went to visit Ryanair HQ to see how aircraft were dispatched in the early morning to see if they could learn lessons on managing waiting lists and hospital overcrowding.
The visit was recommended and set up by Michael Cawley, the former deputy chief at the no-frills airline, who now sits on the HSE board.
In emails with HSE CEO Bernard Gloster, Mr Cawley said the health service could draw on Ryanair’s experience of “how we deal with punctuality.”
A message said: “The key to good punctuality is to get the first wave of aircraft away on time first thing in the morning.
“We have ninety-five bases from which close to six hundred aircraft depart every morning between 5am and 8am Irish time. At 9am, we hold a conference call at which all ninety-five bases report their punctuality and identify the reasons, if any, for delays.”
Mr Cawley said a similar approach could be adapted for the HSE with a daily call overseen by a senior executive, or the CEO himself, when possible.
The former Ryanair deputy chief said if issues arose, solutions would be discussed on the phone and “implemented immediately.”
Mr Cawley said within the airline there was an expectation of “zero delays” and that each airport manager would have an “immediate and viable solution” for any problem.
He added: “We have run this process every day for the last twenty-five years and it has hugely improved our performance.
“I would be happy to arrange for you and colleagues to see how this process works and to assist with the implementation of a similar one in the HSE.”
Mr Cawley said the approach should first be applied to tackling overcrowding and hospital trolleys for a “quick win” before moving onto waiting lists.
He wrote: “Some of my ideas are fairly radical but you won’t make an omelette without breaking a few eggs and showing real resolve on cost reduction.”
He said every option needed to be on the table when it came to health budgets.
Among his early suggestions were cancelling all external consultancy contracts and training budgets except for those required by regulatory bodies.
Mr Cawley said his analysis of accounts suggested “very high” costs for legal and professional, bad debts, and computers – and that all needed to be closely examined.
He also said that the “best ideas for cost savings and efficiencies” often came from staff on the frontline.
“We should not be afraid to ask staff and management for suggestions particularly if we can promise that any savings will be reinvested in frontline services,” he added.
In response, HSE boss Bernard Gloster said he would “welcome the opportunity” to learn from the Ryanair experience.
He suggested that he and a senior colleague would take part first before a larger group of health officials – including hospital managers and CEOs – would visit.
Mr Gloster wrote: “I would also be happy in the height of our winter calls for you to attend one and see our approach with perhaps then sharing insights into how the Ryanair piece would benefit most.
“You might let me know your thoughts but would certainly regardless love to see the Ryanair piece for myself.”
In the end, just a single meeting took place as Mr Cawley brought forward a large number of suggestions around cost-cutting in the health service.