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Purpose

– The purpose of this paper is to explain the path that the Irish health system has taken towards achieving good clinical governance, exploring the historical influences on its’ development, some of the major initiatives that have been implemented and the obstacles that have been encountered.

Design/methodology/approach

– The paper draws on the author's experience researching and teaching in health systems and healthcare management.

Findings

– The paper offers some explanations for why earlier attempts failed to change the system as well as why recent attempts have met with more success. Greater efforts need to be made to progress clinical governance in the primary care services. In addition it is argued that there is a need to institute systems that enable learning form errors, to involve the public and patient groups and to invest in research that enables answers to the how and why questions that are so often neglected in the reform process.

Originality/value

– The paper discusses clinical governance in the Irish Health system and identifies some of the challenges yet to be addressed, many of which are common to clinical governance efforts in other jurisdictions.

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