independent

Sunday 20 April 2014

John Downing: Oh really, Reilly: the good doctor is still dispensing bad medicine

IN EIGHT weeks' time, Dr James Reilly will have been two years in charge of the Health Department which spends roughly one-third of our tax resources.

Like many of us, the year 2012 was tough for him and he is understandably hoping for far better professional weather in the coming year. With that end in mind, he yesterday gave a major interview in which he laid some things on the line for 2013.

It is hard to sum up just how smug and self-serving the health minister showed himself to be in that interview. To get some idea of it all, let's spool back a bit and look at some things in context.

Dr Reilly, now aged 57, was first elected to the Dail for Dublin North in May 2007. By June 2010 he was the Fine Gael deputy leader, and by March 2011 he was given the task of forwarding daring plans for a decent health service – something which a generation of governments failed to do.

With less than four years' Dail experience, Dr Reilly's appointment was a pretty audacious move by a Taoiseach who had himself spent 36 years learning his own trade. But Dr Reilly's rise was partly based on his experience in the world of medicine and medical politics, including a stint as president of the doctors' union, the Irish Medical Organisation.

Dr Reilly had also backed Enda Kenny when his lieutenants tried to ditch him in June 2010. Dr Reilly's reward was enhanced by the need for a Dublin-based deputy leader to balance Kenny's rural background.

He began ministerial life with the air of a 'poacher-turned-gamekeeper' – a former doctors' union person who could tackle the self-interested groups in our health service. His tantalising promise was the dismantling of the current hotch-potch non-system which grew based on those interest groups' demands.

Dr Reilly reasonably told us it would take two government terms to effect the planned move to a free-at-point of service health care model. It would be funded by mandatory health insurance, with people below a certain income being covered free by the State. The Netherlands was cited as the model and many of us who pay three times for health services – through taxes, health insurance and doctors' and pharmacists' bills – were extremely interested.

Two things have happened since then. We can't blame Dr Reilly for the first one which is that the Netherlands' health system is in deep financial and organisational trouble.

But we are well entitled to ask where is the first step on the road to Irish medical Utopia – the publication of a discussion document. It was promised early in the first term of government, but two years on we are still waiting.

The best proof that he has long ago lost his 'new-boy' gloss comes in his talk of battles to haul the VHI into the 21st century and ongoing wars with doctors' unions. Each of these suggest he is far from winning.

Like all his predecessors in this difficult job, Dr Reilly can point to some progress. He insisted in this interview with 'The Sunday Business Post' that there are fewer sick people on hospital trolleys and people have less of a wait for elective surgery.

But anyone who has had the misfortune to spend hour after hour waiting in a hospital will not need reminding of just how under-pressure that system is. The interviewer pointed out that some 350,000 people are waiting for out-patient medical appointments.

And the minister's response? He confidently pledged that nobody would be waiting more than a year for an appointment once the most urgent cases were dealt with. He is entitled to full marks for cheek – but very little else.

For many people, Dr Reilly will be remembered in 2012 for becoming the first government minister to be named in 'Stubbs Gazette' for court registered unpaid debt. Many will also recall his extraordinary non-explanations of why he added five sites for new primary care centres, two of which were in his own constituency.

He lost his junior health minister, Roisin Shortall, amid that controversy and strained coalition relations with Labour. Harking back to his Irish Medical Organisation days, it is interesting to note his pledge in this interview to co-operate but not comment on investigations into how the IMO's boss, George McNeice, got an initial €20m retirement package entitlement.

But Dr Reilly has revealed his big bugbear is the media who are unduly negative about health and in general. "The media seems to be consumed with the negative," he said.

So, there we have it – it was the media all the time screwing over our health system.

The year 2012 was a tough one for the health minister but his opening foray in 2013 is not encouraging.

Irish Independent

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