News Fionnan Sheahan

Thursday 18 September 2014

Leo spends his political capital on health policy

Varadkar is combining the mind of a doctor with the instincts of a politician, writes 
Fionnan Sheahan

Published 10/08/2014 | 00:00

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State Of Health: Leo Varadkar is not afraid to speak his mind — but his outspoken nature means he has at time rubbed up fellow ministers the wrong way. Photo: Gerry Mooney

Assess, act, explain.

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Leo Varadkar is said by associates to be putting the basics of his practical medical training to good use in his new role. The Health Minister may have the mind of a doctor, but he has instincts of a politician - unlike his predecessor.

The style with which he parked the rollout of Universal Health Insurance this week is in keeping with his approach.

Weigh up the problem, make the decision, rather than avoiding it, then level with people.

He took it head on, setting out what he was planning to do, without any sugar-coating or over-promising.

A qualified doctor, who had a brief flirtation with studying to become a lawyer, there are easier, and more lucrative, ways for an intelligent 35-year-old to make a living.

When a staff member of his moved on recently to a better-paying job in the private sector, Varadkar briefly wondered aloud to friends why he was opting to stick with the hassle of politics.

Part of his make-up though is never really seeing politics as a life-long commitment. Hence, he's not afraid of losing his seat as he knows there's lots more to life he can turn his hand to. Medicine is in the blood. His father, Ashok, is a GP, and his mother, Miriam, a nurse. His two sisters, Sophie and Sonia, are both doctors too.

That lack of fear means he's not afraid to speak his mind, even if it means offending some people.

But the outspoken nature has rubbed fellow ministers up the wrong way at times.

The dig at Dr James Reilly, for locating two primary care centres in his constituency, where he said it "does look like" stroke politics, caused problems.

Likewise, his description of the Garda whistleblowers as "distinguished" resulted in a simmering controversy for Alan Shatter boiling over.

Colleagues in Government feel he can make a mess for everyone else to clean up. His solo runs can undermine the rest of the team.

Prior to the Cabinet reshuffle, a number of the Taoiseach's confidantes were suggesting he was an unsuitable choice for Health Minister. Varadkar didn't take kindly to being described as an unsafe pair of hands.

But some of Kenny's closer aides viewed him as an obvious choice for the job. His opening act in his new role shows he is capable of being rock solid.

If Reilly had announced a rowback on UHI, it would have been seen as a concession of failure. When Varadkar did it this week, it was viewed as a sensible approach to a flawed and ill-conceived policy.

The messenger is often as important as the message.

Varadkar is using the political capital he has built up with the public, through his reputation for straight-talking, to present an honest account of where he sees the health service going.

During his earlier days, he used to get three people at a time to offer a critique on his Dail and media performances.

"He's always looking to learn," a party handler says.

After a month of analysing his brief, Varadkar decided the solution was to not try to do all the reforms at once. He hasn't quite abandoned Reilly's health policies, which formed a central plank of Fine Gael's general election strategy. He has just identified what is achievable by the next general election.

Proceeding slowly with free GP care is possible, so too is moving to the new hospital organisation structure of groups and the funding model of 'money follows the patient'.

Parked is UHI and the 
rapid abolition of the HSE.

Finding the funds for free GP care, at an estimated total cost of €400m a year will be a challenge. Ironically, for the Fine Gael figure regarded as most partisan and right-wing, he will have the support of the Labour Party. The junior coalition party were never wedded to UHI, but wanted to bring in universal primary care. Labour will now have to foot the bill to achieve the ambition.

Varadkar's stance has also gone down well with Fine Gael backbenchers, who had tired of Reilly's inadequacies and were getting grief over the mooted cost of the change to UHI.

Becoming the Health Minister will arguably make or break Varadkar's career and any future leadership prospects. Fine Gael's long-term leadership contest is regarded as a race between him and Simon Coveney. Add in Frances Fitzgerald to the field if a vacancy appears in the shorter term.

"I just think he wants to be Taoiseach," says a party colleague who has worked with him since before he became a TD.

"Leo has a great chance now. If he makes any sort of headway at all in health, he'd be unbeatable," a party TD told the Sunday Independent.

Varadkar is dismissive of people ascribing strategic motives to his behaviour. The whistleblower sounding off was interpreted as an effort to get one over Coveney. Supporters say he viewed it as way off the mark and he was acting out of conviction.

However, in the past six months, backbenchers say the two putative leaders are making a greater effort. Suddenly, the pair are awkwardly turning up in the Dail Bar attempting to be convivial.

"There was no social element or conversational element before. Leo has his cheerleaders in the Five-A-Side Club. Tom Hayes is constantly on to Coveney to go in and be sociable and has him shoehorned in there," a backbencher said.

Neither Varadkar nor Coveney are said to have a fellow TD who would be regarded as a trusty sidekick. But the younger, more independent-minded TDs seem to be aligning with Varadkar. And he does view it as important to have support in the parliamentary party to provide back-up on policy.

Varadkar's principles will now be put to the test as he vies to ensure health is not a graveyard for another career.

Sunday Independent

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