Friday 18 October 2019

Health mud beginning to stick to Leo

One year in and it's going wrong for Minister Varadkar

Leo Varadkar
Leo Varadkar

Daniel McConnell

It was great for a while, wasn't it? The more Leo Varadkar says he would do nothing about the health system, the more people thought he was deadly.

For months after becoming health minister, Varadkar won plaudit after plaudit for lowering expectations for what he would do before the general election.

But, a year into his reign, King Leo's crown is beginning to slip, as the murky reality of the worst department of government begins to get the better of him.

It is now a measure of how his first year has gone, one suspects that Taoiseach Enda Kenny would be more than happy to reappoint Leo Varadkar to the quagmire of the Department of Health after the next election.

Varadkar's move to Hawkins House one year ago was significant on two fronts.

From the Government's perspective, it put an end to the shambolic era of Dr James Reilly, who, through his Universal Health Insurance plan, placed the financial viability of the State at risk, according to money minister Brendan Howlin.

Three years of over-promising and under-delivering had risked sinking the Coalition on more than one occasion.

Ruairi Quinn, when education minister, famously told his party colleagues at a private meeting that concerns of backbenchers about Dr Reilly were "shared by their Cabinet colleagues".

But for Varadkar, the move into health would be the greatest test of his political and intellectual skill set, given the myriad of daily crises faced. If Varadkar managed to get to the next election unscathed, then his leadership ambitions or at least his promotion ambitions will not have been dented.

So, on taking office, Varadkar immediately, and very deliberately, set about doing everything differently from Reilly.

From his first press conference on the plinth in Leinster House on the day the reshuffle happened, Varadkar lowered everyone's expectations as to what he would do.

He had only 18 months, couldn't fix a health system in that time, he said. Rather he would tinker with a few bits and bobs, put some manners on the budget and hopefully hand the grenade over to someone else.

By immediately saying he wasn't going to bother to try and transform the system, people couldn't ask him why he wasn't transforming the health system.

A short time later, he dumped Reilly's beloved child of UHI from a height, saying the timescale put forward by his bumbling predecessor was too ambitious. In political speak, this meant it was all but dead.

Being "slapped down" by Kenny at the start of September over UHI appeared to only increase the lusty anticipation of what life under Leo would be like within Fine Gael.

Varadkar also began talking of the need for a "realistic budget" in Health for 2015 in the run-up to the October Budget day, and for the first time since taking office in 2011, Howlin had the capacity to accede to that request. And unlike Reilly, who lost out time and time again, the new minister got the extra funds.

His personal approval rating soared after he became the first openly gay minister to reveal his sexuality earlier this year.

But the last six months have seen a barrage of negative news stories which are beginning to take the gloss off Varadkar's halo.

We have had the disturbing Prime Time expose into disability care added to a series of negative inspection reports into disability services, deeply alarming stories about the standard of care at the country's maternity hospitals, record-high numbers of patients waiting on trolleys as well as ever-lengthening waiting times for treatments.

Latest figures show that the number of people waiting more than a year for an outpatient appointment rose to 61,400 at the end of December, with 385,781 in total waiting to be seen.

He was caught on the hop when, in January, he was on his holidays in Miami when the number of patients on trolleys topped 600.

In April, Varadkar got an additional €70m to address hospital overcrowding and to cut waiting times for patients.

Most of the money went on the nursing home support scheme in a bid to remove so-called "bed blockers" out of the system, but critics have branded this as a sticking-plaster solution.

Clinicians have argued that since the 1980s, almost 2,500 acute hospital beds have been removed from the system, and with an ageing population, the shortfall has resulted in the emergency department log jams. They argue the way to resolve the issue is to open more beds.

Varadkar has also come in for criticism from his own friend and former colleague, Lucinda Creighton, after he appeared to suggest UHI was still alive. Creighton has expressed astonishment at the revelation that just five members of staff within the Department of Health are working on the government's highly touted Universal Health Insurance policy.

Commenting on the skeleton nature of the staff, Ms Creighton said: "The revelation that just five staff are now assigned to the Universal Health Insurance unit within the Department of Health in 2015 is indicative of how far the issue has slipped down the Coalition political priority list."

But even this week, Varadkar has drawn the ire of Howlin after he suggested he would need another €1bn to safely deliver healthcare.

Howlin, on Wednesday, said: "A billion seems to be the annual figure that ministers for health demand, it's a nice round figure, and for the four years I've been here, it's the sum looked for."

Varadkar is clearly a capable politician and a man of real intellect, but the stark realities appear to be getting the better of him.

Sunday Independent

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