News Gerard O'Regan

Saturday 20 September 2014

Health Minister Varadkar is a man with a fighting chance

Published 21/08/2014 | 02:30

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Minister for Health Leo Varadkar. Photo credit: Frank Mc Grath
Minister for Health Leo Varadkar. Photo credit: Frank Mc Grath

MIKE Tyson, the former fearsome and frightening World Heavyweight Boxing Champion, just might have some timely advice for Leo Varadkar. Tyson has been in some tight corners in his time, but always prided himself on being ultra-prepared for the worst that might happen. At the end of his career he became convinced the unexpected is the most ominous enemy of all. But there is little that can be done to prepare for it. "Everybody has a plan until they get punched in the face," he concluded.

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So it is with our new Health Minister, who has emerged as a kind of Steve Silvermint for the Fine Gael Party. There is clearly more than a fair wind at his back, as he takes over a portfolio that over the years has bested some really big-name politicians. However, he has started the new job in a swoon of expectancy. There is a palpable undercurrent that if anybody can get to grips with some of its intractable dilemmas, he can. And the advice as to what he must do has been coming thick and fast.

As James Reilly - who it seems was also bested by the system - will tell anybody who cares to listen, there are no easy options left in the provision of healthcare in Ireland. It's fraught on nearly every front.

Varadkar has made his mark on the political scene by generating an aura of focused self-assurance. He has also justifiably attracted much praise for being a reasonably straight talker, in a world where the smoke and mirrors of political spin and double-speak, dominate. This is the core of his appeal with both the public and the media.

But as Mike Tyson might warn, the road to perdition is paved with well-planned, well-thought-out, good intentions. All it needs is one sucker punch from the most daunting government department of them all, and the Varadkar sheen will disappear overnight. His predecessors - whose performance cards would rate somewhere between mediocre to weak - are testament that overseeing our healthcare system is fraught with risk. All were fearful of taking some of the really tough decisions because of obvious political risk. This is the main reason why so much inefficiency, wastage, and lack of accountability should now be confronted by the new minister.

Like many people starting a high-profile, high-risk job, Varadkar has made full use of his honeymoon period to ditch some awkward stuff from his in-tray.

He has already told us the multi-million overspend for this year must remain. And of course Universal Health Insurance has been kicked into Never Never land. It will be unfortunate - if Varadkar really has innovative plans for the Department - that all too soon the Government will be on the home stretch to the next general election.

We can only hope playing the safe middle ground will go against his gut instincts, that he will take on some of the really big time challenges. In any case, given the huge hype of expectancy which has surrounded him getting the job, he had better be seen to deliver from the viewpoint of his own political future.

He would also do well to remember all the hoopla which surrounded the appointment of the last man in the gap. Dr James Reilly was also a medical doctor, and he had made it clear it was his life's ambition to be Health Minister. How much time did he spend baying at the last government when in opposition, taunting them with what he would do, if only given the chance to implement his vision.

Dr Reilly certainly had passion for the job - and in fairness, had his successes. But the overall impression is that of a ministerial career unfulfilled.

The biggest single challenge facing the new minister is to implement what has been described as a culture of "responsibility with consequence". This is no easy task in a sprawling, sluggish and overmanned management system. When things go wrong in the Irish health services, experience has shown there is nobody to take the rap.

Political interference is a key problem. The politicisation of the health service is manifest in the fact that in the current climate, it is simply impossible to even raise the question of medical card abuse. It is now a complete no-go area for every politician in Leinster House. An issue such as this will be the real test of the Varadkar capacity for straight talking.

And so we wait to see what Leo will do. If he makes a real go of it, it could be a huge boost for FG's re-election prospects. And it will surely make the Health Minister the heir apparent to Enda Kenny. But if Mike Tyson was his coach for the fight ahead, he would surely say, beware - watch out for that unexpected punch in the face.

Gerard O'Regan

Irish Independent

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