These past few weeks have seen huge upheaval in the Irish health system.

Some of the top people have departed, or are going soon.

The first big shocker is the decision of the head of the Health Service Executive, Paul Reid to leave. He is only in the job three years and on a salary of about €420,000 a year.

He has no big plans yet and says he wants to spend more time with his family.

It’s been a tough few years for sure for Paul Reid, with the Covid-19 pandemic and a massive criminal cyber attack on the HSE systems.

The HSE has mostly recovered from the cyber attack but still has to deal with over 880 Covid-19 cases in hospitals.

Mr Reid leaves the HSE at the end of the year and it will be a key post to be filled.

Others going, or gone are Angela Fitzgerald, deputy HSE National Director of Acute Operations and Anne O’ Connor, HSE Chief Operations Officer. These are crucial posts.

Angela Fitzgerald has gone to the Health Information & Quality Authority which is a health watchdog, so for it’s a bit of poacher turned gamekeeper for her as she will be holding her former employer to account.

In the case of Anne O’ Connor, she is heading to the VHI.

Not only has the HSE lost two senior management figures but two women also.

With Reid going as well, it leaves a big gap to fill at the top, which is not good news for an organisation rarely out of the headlines with long hospital waiting lists, emergency department overcrowding and a huge reform agenda to deliver on.

The other big departure is of course Dr Tony Holohan, the chief medical officer at the Department of Health, as well as his deputy CMO, Dr Ronan Glynn.

Dr Holohan leaves after 22 years and as one of the most well-known figures from the Covid-19 pandemic.

He finished up on July 1. It’s not clear yet where is is heading next but he said in his departure address that he will do some pro bono work for a while in healthcare.

He too wants to spend more time with his family adding wryly in his departure address “whether they like it or not ! “

So all in all, a big shake-up and lots of new faces to come soon to deal with the hot potato that is always health.