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Roisin Shortall exposed the illusion by resigning and yet the health minister still retains his power, writes Elaine Byrne
Real power is about giving others the impression of control.
Machiavelli had three steps to acquire and maintain power. Step one: "The prince must allow the people to elect politicians which are without political autonomy, so that the people have the illusion of ruling themselves."
Roisin Shortall thought she had power when she was appointed as minister of state for primary care.
James Reilly told the Dail in March 2011 that "the precise details" of her role had "not yet been finalised but this is being addressed as a priority". He promised to clarify her position "as soon as possible".
It was not until the following September that the Taoiseach published the details of her job description. Known as a "Delegation of Ministerial Functions", this one-page document outlined her delegated powers.
Shortall was given responsibility for legislation such as the 1961 Poisons Act, the Control of Clinical Trials Act 1987 and the Pharmaceutical Society of Ireland (Fees) Rules 2008 and 2010.
Revolutionary stuff.
According to the Department of Health's website, primary care is regulated under three key pieces of legislation -- the Health Acts, Health Professionals Regulations and Financial Emergency Measures. Shortall was not delegated any responsibility for these.
She was a minister of state for primary care in name only. This first dawned on her early last summer. Shortall made discreet queries to those with experience within the politics of health administration. The Labour TD finally understood the significance of her diluted Delegation Order.
Her subsequent meeting with the Taoiseach and the Tanaiste that July centred on why her work was being "blocked" and "overruled". Shortall had finally realised that information relevant to position was being withheld from her.
Department of Health officials were between a rock and a hard place. They had to deal with a junior minister who thought she had power but took their instructions on primary care from the senior minister.
"Tough luck" say senior politicians and advisers. That's the way the political world works. Under the Ministers and Secretaries Act, the senior minister controls all the functions of the department because it is the minister who ultimately is accountable for the actions of the department.
But this is different.
Shortall was never actually delegated any powers or duties on primary care in the first place. She occupied an imaginary, Alice in Wonderland existence within the Department of Health.
Reilly indulged her in the same manner as a sleeping dog who's causally taunted by a domesticated cat that has notions of grandeur because it has bigger feline cousins.
Shortall can be forgiven for having such notions. Primary care is a core Labour Party objective, apparently. "It wasn't the usual junior minister job, it was given a very specific agenda of reform," as she told Marian Finucane.
So what now?
The Government News Service on merrionstreet.ie lets slip the Machiavellian intent of the deputy leader and leader of Fine Gael. As you were, thank you very much.
Both Reilly and the Taoiseach issued separate press releases welcoming the appointment of " Alex White TD as a minister of state in the Department of Health." It just slipped their minds to add that crucial phrase, "with responsibility for primary care".
Eamon Gilmore didn't forget when he published two press releases that same day. But so what.
Labour has decided not to demand a revised delegation order which would give
White the delegated statutory responsibilities Shortall required. The Dublin South barrister will instead politely "discuss" this with Reilly. So much for primary health care being a core Labour principle.
Reilly is of the view that primary care is too important and too interlinked with wider healthcare policy for it to be delegated to a junior minister. He would say that of course. Ministers are not in the habit of giving up power.
Nonsense.
When Barry Andrews was minister of state for children, his portfolio was interwoven within three different departments. Although he was not a cabinet minister, he sat at cabinet as a "superjunior" because the government partners agreed to place specific priority on his role.
Machiavelli's step two. "The prince must disband the existing army and create a new army under his own control. The prince can use the army to prevent any possible threats to his sovereignty."
In the last 18 months Reilly has overseen the departure of the HSE chair, the HSE board, the VHI chair, the VHI chief executive, the secretary general of his department, Michael Scanlan, and controversially, the chief executive of the HSE, Cathal Magee.
Reilly is now the undisputed Prince of Health. There is no dissent, anymore, it appears.
Two Freedom of Information requests disclose the manner in which Reilly has exercised power.
In January, the Medical Independent published correspondence from Magee to Scanlan. In an unusual move, Magee requested "appropriate arrangements" regarding "governance in our system" which would "recognise and reflect the current statutory responsibilities of the HSE and the issues outlined in the Travers Report in relation to advisers".
When the HSE chief cites a report which exposed spectacular internal governance failures then a flashing red light should immediately go off. Not so.
The Examiner published details of a FoI last week which revealed that the secretary general of health met with Reilly. Scanlan was concerned about Reilly's "inappropriate" involvement of his private civil service secretary in political work.
Scanlan and Magee are now gone. On Reilly's recommendation, Ambrose McLoughlin, the first outsider to be selected as secretary general, was appointed. Tony O'Brien was appointed as HSE chief without going through the stated government policy of open competition.
The thunderous silence of the young turk Fine Gael ministers and Labour's ethical wing has been doing a roaring trade.
For example, Gilmore had initially demanded to see the written documentation which explained why the two proposed primary care centres were in Reilly's constituency.
In the end, the leader of the Labour Party agreed to accept the oral assurances from Reilly's new appointees -- McLoughlin and O'Brien.
All's well so. "A prince who wishes to remain in power should not always be good." Machiavelli's third step.
