In 2005, Ireland began to transform the way it delivers health services to its 4.5 million people by consolidating responsibility for primary care, hospital care, and many social services into a single organization, the Health Service Executive (HSE). Despite strong initial resistance to many of its reforms, as well as hostile political and media criticism, the HSE has improved care delivery significantly. Waiting lists have declined sharply. More patients have access to high-quality primary care. Hospital quality and safety have improved.

In this interview, Brendan Drumm, the HSE’s first CEO, speaks frankly about what has been achieved, what is still in process, and what challenges he has faced. Professor Drumm, who is stepping down as CEO this year after completing his five-year term, also outlines what he learned at the HSE’s helm. The interview was conducted by Martin Dewhurst, a director in McKinsey’s London and Dublin offices.