Friday 21 October 2016

Johnny Fallon: HSE in danger of turning into a political football again

Published 01/02/2013 | 13:11

THE government continues to struggle on in the Dáil this week. Yet again James Reilly has caused them some problems over hospital funding for TD colleagues but nothing they can’t get over. The opposition may call for heads but they are unlikely to get them just yet. Every party in the Dáil knows that while the actions may not sit right with many, if the Minister were to resign over this issue it would fall back on every TD in the house eventually.

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There is of course a very real problem with Minister Reilly’s actions but it is too delicate for the politicians to start splitting hairs. The problem was not so much that constituency TDs lobbied on behalf of their hospital but rather that the decision seemed to be taken over the heads of the HSE and with poor communication of the decision by the minister.

This poses questions because the HSE is set to return to ministerial control. This brings us back full circle. Cast your mind back before the HSE was created. There were problems with health boards and the perception of political interference. In an attempt to rid the system of this the monolithic HSE was created as an independent body. No more could politicians rule the roost and interfere in the process.

That seemed like a great idea. Of course we realised quickly that they had created a monster. The HSE was unaccountable, its top people earning well in excess of the Minister for Health. It did little to solve problems in the system and people found interaction with it even worse.

More frustratingly, it seemed that the government had also lost control of it, the elected representatives of the people could ask questions but the HSE showed itself not to be answerable to such representatives. This was not the solution people wanted.

When James Reilly took over he knew that reforming health was going to be a tough job and that he had given a lot of hostages to fortune. He also knew that the HSE could not remain in its current state if government plans for health were to be seen through. The first change that came was to bring the HSE back into line and make it part of the Ministers jobs again. This would return accountability. That is a good thing. In an ideal world things should have progressed nicely.

Of course it’s all very nice in theory but then politicians go and do what politicians do best, start messing. Now any constituency TD has a right, and obligation, to listen to constituents and help them make their case. There is no difficulty whatsoever in this, in fact it’s often a good thing.

The safeguard is that the Minister hearing the representations is still meant to make a fair decision in conjunction with the relevant authorities. The lobbying may help ensure no valid information is overlooked and all sides of the case are understood, but, it should not lead to a decision that doesn’t stand up or adversely affects a more deserving case.

In the current matter we just don’t know on that score, but we do know that the Minister seems to have decided on the matter, informed the TDs and the HSE were told after the event. This smacks of a political decision. Now the difference is too slight for it to cause further problems unless new information comes to light.

James Reilly is going nowhere until Labour say he must. Labour will only make that call when they have incontrovertible proof or the public opinion is high on an issue. In this case they don’t want to be seen to be arguing against TDs making the case for their constituency, because every TD does that.

For instance, Luke Flanagan criticised the decision to spend public funds in this manner while some months ago he announced that he was using his Independent TD’s allowance (central taxpayers’ money) to fund community projects in his constituency. So you see the problem? Even though it might be well meaning, taxpayers’ money is used for constituency purposes. Labour know that despite the problems in the way the Minister took the decision they can’t really start a war on this issue.

The bigger problem is that the matter has served to further erode public confidence in James Reilly. With most of the major reforms in health still to come, this is going to catch up sooner or later. Tough decisions don’t get easier when your popularity and trust is at rock bottom.

The system has got to face its old problems once again. Only a short few months after the HSE was brought back under political control, for very good reasons, it finds another story of politicians starting to dominate just like the old days and interfere in a decision-making process for their own ends.

It would be great to have the HSE accountable to the Minister, to have someone we can elect actually running things, if only we could elect someone that wasn’t obsessed with being re-elected.

Johnny Fallon is a political commentator

Follow @jonnyfallon

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