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Health service has 'complacent' attitude to money

AN "unbelievably complacent and casual" attitude to the spending of taxpayers' money was found in every aspect of the health service examined by the Brennan Commission, the chair of the Commission, Prof Niamh Brennan, has claimed.

She told the annual economists' workshop in Kenmare there was not so much a black hole in the health service, as so many holes that it was more like a colander than a black hole. She repeated her criticisms of the Department of Health for its slowness in implementing the recommendations of the Commission.

"Those who say it will take ten years do not have the can-do, make-it-happen attitude that is required for successful implementation," Prof Brennan said. "The kind of person we need running the health service is Michael O'Leary - but not as shy and self-effacing as Michael O'Leary!"

It was critical that an interim board for the proposed Health Service Executive be appointed immediately. "It is now four months since the Government said it would appoint the interim board 'shortly'," she said.

Instead, the Minister for Health had set up 14 committees, co-chaired by Department officials and chief executives of the health boards. "The health boards are a vested interest. In the meantime, there is a risk that existing managements in the boards may put in place mechanisms that make change more difficult. Committees don't change things; people change things," she said.

Ann Broekhoven, an executive with private health insurer BUPA, said the Exchequer did not have the money to invest on the scale necessary to strengthen the health system. "The private sector has both the appetite for risk and the necessary investment and skills," she said.

Earlier at the conference, the Secretary General of the Department of Transport, Julie O'Neill, said it was "only a matter of time" before there was a successful court challenge to the Dublin Bus monopoly, as happened with the restriction of taxi licences.

"I happen to agree with the approach which was taken to the taxi market, but I would not support it for the bus services," Ms O'Neill said.

Transport Minister Seamus Brennan faces strong union opposition over plans to introduce competition in Dublin bus services.

Anne Ribault-O'Reilly of the Competition Authority said bus services in Dublin and Cork lag behind those of similar European cities. Bus services were well suited to competition because they were not a natural monopoly and the costs of entering and leaving the industry were not high.

"Paradoxically, the benefits of competition have been clearly demonstrated. The more consumer-oriented service to Dublin Airport since the entry of Aircoach shows competition was more important than ownership of the bus service," she said.

The chief economist at the employers' body IBEC described as "absolute poppycock" a suggestion that employers should pay a levy towards the cost of benchmarking pay awards. Jim Power, economist at Friends First said IBEC had signed up to a very damaging deal.

But David Croughan said IBEC had no involvement in the size of the 9pc pay award. "Benchmarking is meant to put an end to damaging leapfrog pay claims. What we have said is that changed economic circumstances mean it should be phased in over a longer period."

The cost of relativity claims was highlighted by Prof Brennan. The 2001 pay award for childcare workers cost ?11m a year. But the knock-on effects to linked grades is expected to come to around ?35m a year.

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