The Health Service Executive has brought in a former Labour Court chairman to engage with senior management in the health service in the south and southwest after several concerns were raised about operational issues.The Irish Times understands a number of senior managers in the HSE South West region wrote to then chief executive Bernard Gloster last year, setting out concerns regarding governance, financial controls and patient safety issues.The managers in the region are understood to have contacted Gloster’s successor, Anne O’Connor, several weeks ago.O’Connor placed HSE South West, as well as two other regions, in what is known as “tier three escalation” in April. This essentially involves the introduction of employment controls and greater scrutiny on spending.A pause on recruitment was introduced in those regions across all non-frontline, non-critical posts. Exceptions to these restrictions require a business case to be approved by the regional executive officer.O’Connor warned in April that the financial position in the HSE had worsened, and it had recorded an overall overrun across the State of about €250 million in the first quarter.The HSE is understood to have brought in former Labour Court chairman Kevin Foley to engage with senior management in HSE South West. The process is understood to be ongoing. A HSE spokeswoman said its chief executive was “aware of a number of issues that have arisen in the South West”.“There is currently a process in place to support resolution and it would not be appropriate to comment further on it at this point,” she said.At the Oireachtas health committee on Wednesday, Labour TD Marie Sherlock said there were “all sorts of difficulties in the South West”.In reply, O’Connor said “there have been concerns raised about the South West which I am dealing with”.O’Connor also told the committee the health service had recorded a deficit of €400 million in the five months to May. However, she said the growth in the level of overspending had stabilised and some of the regions that ran up the largest deficits earlier this year “had come back the most in May”.She said there were no plans at this stage to place any of the HSE regions into a higher level of escalation than those already in place.New regional structures were established in the Health Service Executive in 2024 as part of Government healthcare reforms, with each area responsible for providing hospital and community care for the populations they serve. Each region is run by its own chief executive and senior management team.