At the All-Ireland Conference on Integrated Care (AICIC25), Bernard Gloster, CEO of the Health Service Executive (HSE), offered a candid, reflective, and values-driven view of integrated care—one rooted in the “real world” experience of delivering health and social services.
Speaking with the weight of 37 years in public service, Gloster didn’t bring slides or scripts. Instead, he brought clarity: integration isn’t a diagram or a job title—it’s a mindset, a collective behaviour, and a daily discipline.
What It Means for the Workforce
Gloster’s message to Ireland’s health and care workforce was both a challenge and a reassurance: integrated care can’t be achieved by structures alone, and it certainly can’t be mandated from above. It lives in the relationships between professionals, the shared purpose that unites teams, and the commitment to put patients—not professional silos—at the centre.
“We don’t employ people for the sake of it. We employ them to be part of something bigger… The sum of which should be greater than any individual part.”
He cautioned against viewing integration as a check-box reform or something that can be solved by redrawing organisational charts:
“Yes, structures are important. But they’re not sufficient. Integration transcends that—it’s about how we behave with each other.”
He acknowledged a truth well known to frontline staff: care is complex, disagreement is natural, and collaboration is hard. But disagreement, he argued, is not a problem unless it becomes personal or obstructive. What matters most is that professionals stay grounded in their shared goal—to serve people better.
And he offered a word of warning about the risks of specialism:
“Every time we create a new specialist role, we increase the risk of disintegration. Specialism must always serve the broader system, not silo it.”
What It Means for Patients and the Public
Gloster made it clear that integration means nothing if it doesn't translate into better care for the public. His test for whether integration is working is simple:
“Does my definition of integration mean something to the person waiting on a hospital trolley, or to the person caring for a loved one at home?”
Throughout his remarks, he brought attention back to the lived experience of patients and families, urging attendees to avoid abstraction and jargon. He reminded us that systems thinking must always lead to life-improving outcomes for individuals—not just better meetings or neater structures.
“We talk about five and a half million people. But every day we must essentialise that to one person. Because care happens one person at a time.”
A Continuous Process, Not a Destination
Perhaps the most important takeaway was this: integrated care is not a destination, but an ongoing, evolving process of improvement. It is not something we “achieve” once and for all. It requires daily recommitment, honesty about what’s not working, and humility about what still needs to change.
“The day we say, ‘tick, done,’ is the day what we’ve achieved will begin to slip away.”
So Where Do We Go From Here?
Bernard Gloster’s speech called for maturity, realism, and purpose. For the workforce, it means staying connected to the people we serve, not just the roles we hold. For leaders, it means prioritising relationships over reporting lines. And for patients, it means expecting a system that works with them, not around them.
As Ireland continues its journey toward integrated care, Gloster left us with a powerful reminder:
“We are public servants. We come second to the public interest. Integration is how we make that real.”
Access Bernard Gloster’s full presentation here.
Fiona Lyne
International Foundation for Integrated Care (IFIC)