Thursday 29 September 2016

'I am not so naive that I think I can make all the problems go away'

Published 07/02/2016 | 02:30

HEALTH MINISTER: Leo Varadkar has a constituency map marked with all of the areas that he has to cover for the election. Photo: Collins
HEALTH MINISTER: Leo Varadkar has a constituency map marked with all of the areas that he has to cover for the election. Photo: Collins

Minister for Health Leo Varadkar talks to Niamh Horan about politics, his ambitions and his one time experience waiting in an A&E department.

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Leo Varadkar has an impeccable 'bedside manner'.

Soft spoken, super-smooth and confident - his doctor training has enabled him to deliver bad news - and stay removed from the situation. It preserves his popularity as waiting lists soar and an endless stream of personal stories flood the airwaves.

In the past year, among the hundreds of crisis cases, there was the 93-year-old 'Essie' who spent 29 hours on a trolley at Beaumont Hospital; 94-year-old 'Doris', laid up on a trolley for 50 hours at the same hospital; and the 102-year-old frail patient who spent 26 hours on a trolley at Tallaght. Afterwards, a consultant called it a "human rights abuse", akin to "torture".

I wonder how Leo felt, on a human level, reading the stories.

"Obviously, nobody likes to read or hear about anyone having a bad experience in our hospitals," he says, settling in behind his desk.

"I am not so naive to think that I can make every problem in the health service go away. No minister can. And never will be able to. But it does make you more determined to try and make things better."

After three days trying to pin the health minister down, he has finally agreed to talk. His press advisor places a dictaphone on the table and sits in on the interview, over my shoulder.

In the next room, a team of helpers are busy pushing his election campaign.

Varadkar shows me a map of his constituency area, West Dublin, which he has to cover in the coming weeks. Not unlike the strategy board game 'Risk', he has allocated a colour to each of his enemies: Joan Burton, Joe Higgins and Ruth Coppinger, while pinning his own colour to the estates he attempts to capture as he goes.

"We literally have half an hour…" he reminds me, "I'm knocking on doors."

His work as a GP and as a doctor in an accident and emergency (A&E) units have tied in nicely with his meteoric rise in politics to award him the country's top job in health. He has previously worked 36-hour shifts as a doctor, often missing out on a night's sleep. But rather than finding it stressful, he says: "I quite liked the buzz of being busy."

Last year, he declined an invitation by the Irish Nurses and Midwives Organisation (INMO) to work a 12-hour shift alongside them in an A&E because "they never formally asked".

"I would have thought that rather than demanding I do something through the media - that they might have maybe written to me and asked me if I would like to."

He explains how, contrary to popular belief, more beds and more resources do not relieve overcrowding in some Irish hospitals. Instead, he says, it can cause staff to take their foot off the gas.

"What can happen in some hospitals is sometimes, when they have more beds and more resources, that's what kind of slows it down."

Why?

"Because they [hospital staff] don't feel as much under pressure. So when a hospital is very crowded, there will be a real push to make sure people get their X-rays, get their tests and, you know, 'let's get them out in four days'.

"When a hospital isn't under as much pressure, you start to see things slowing down and it might take five, six, seven days to get the person discharged and that's the length of stay, so it's all these different factors come into play all the time."

He has surveyed eight A&E wards in the past year. But I wonder if has ever been at the other side of the fence.

"As a patient?" he asks, surprised.

Yes. Waiting in a waiting room - beside everyone else?

"Well, I had a minor injury [once] and, as is often the case… I was seen quite quickly."

How long was his waiting time?

"Less than an hour."

Which emergency department was it?

"I don't want to say," he replies. "That's the only time I've ever had to attend an emergency department as a patient."

I tell him he is lucky.

"[It is important] not to think that the worst case that always appears in the newspaper is the normal or average experience, because it actually isn't," he explains.

Have you ever had the misfortune of spending time on a hospital trolley yourself?

"No. I have never been admitted to hospital... I never needed to be. I am in very good health."

So what is his health insurance policy?

"I have Laya… I don't know exactly what it is."

When I press him, he says he pays €700 a year for the package, which covers all of the public hospitals and several private.

Does it entitle him to a hospital room of his own?

"I don't know the terms and conditions."

One issue for which he has been widely lauded is his position during the same-sex marriage campaign. The 37-year-old was hailed as a hero and leading light for a generation of young people on the cusp of a social revolution. Many involved in the 'Home to Vote' campaign are gearing up to get behind the drive for a referendum on the Eighth Amendment - which equates the right to life of the unborn with the mother's right to life. Many pro-choice campaigners hope it will pave the way for full, safe access to abortion in Ireland.

On record, he has already stated he is "pro-life" and does not want abortion-on-demand introduced here.

"It would be weird to me if the right to property was there [in the Constitution] and not the right to be alive," he laughs.

Where does he believe life begins? He laughs again: "I'm not equipped to answer that. I honestly don't know the answer to that question."

Does he believe it is important we start an open and mature discussion on abortion in Ireland?

"Yeah, I do and that's what we intend to do."

Two minutes later - he shuts down a list of questions on his own views. Ranging from foetal abnormalities to cases of rape, incest and suicide - he pointedly refuses, saying he has agreed beforehand the interview wouldn't include the issue of abortion. [Although he was happy before the interview when informed that would be covered].

I explain that as the Minster for Health - a post in which he wishes to continue - it is important people know his views. It is on one of the biggest health and social issues of the next generation. And so, I kick off the list of 'yes or no' questions again.

Do you believe in abortion when the foetus isn't viable?

"Em… I'm sort of conscious that we are going into a general election now and I am running in the general election as a Fine Gael candidate and I am asking people to vote for me as a FG candidate and I am not asking them to vote for me based on my personal or individual views."

He repeats the line eight times over the course of our conversation. I ask if his personal views affect his politics.

"Of course they do… but the mandate I am seeking in the context of a general election is for Fine Gael's position."

Does he believe abortion in Ireland is a class issue?

"No," he laughs. "I don't know what that question means."

I explain that a woman who is wealthy and can afford to travel to the UK has greater access to a safe abortion and medical care than a woman who has no access to similar funds.

"No, I don't think it's a class issue."

And so I ask, as Minister for Health, what he would say to the 12 Irish women who have to travel to the UK every day for an abortion?

"It would depend on each individual."

Is there an indignity in these women having to travel abroad?

He sighs: "I really had understood this interview was going to be about health and politics."

I repeat the question.

"We are running [out of time]."

I move on to his political ambitions to which he tells me: "I would be very happy to stay in health… but obviously, that is a matter entirely for the Taoiseach."

He would consider taking on the role of leader of FG in 2021, if the opportunity arises "and if I am still the same person then as I am now".

Would he like to be Taoiseach some day?

"It is a possibility," he says. "[I hope] it is not something that is even going to arise as a possibility in the next five years."

He doesn't intend to remain in politics past 50: "I would like to travel… I have never lived outside of Ireland. I certainly see myself doing volunteer work… maybe something in the World Health Organisation."

As health minister, people regularly approach him while out socialising: "It used to bother me but you kind of come to accept it. Particularly when you are a public figure and you stick posters of yourself up on poles… the only thing is if people were aggressive or impolite."

Have you ever had that? "Oh yeah."

In what way?

"That's just politics… every second day somebody will accost you with something."

He rejects Labour Minister for Public Expenditure Brendan Howlin's estimation that he is becoming a "social democrat". Instead, he sees himself as "either centre right or a higher class of liberal… somebody who believes in personal freedom, someone who believes in a political economy and in a free market as the best way to create wealth."

He believes his views have become tempered in recent years: "As you get older, life experience allows you to see [things differently]… As a minister, I have had to put myself in other people's shoes... that sort of decision-making process does soften me up a little bit."

What is his biggest strength? "I am willing to trust the public enough to be truthful with them."

On his biggest weakness, he is flummoxed: "What do you think?... My biggest weakness... I'm sure I've loads… hmmmm."

After the soul-searching, his PR man jumps in: "Chocolate!"

"Yeah," Leo laughs. "Chocolate."

"That was a very bad idea," he mutters to his PR man afterwards. And with that, he is back to his group of minders.

Sunday Independent

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