'Do I want to be Taoiseach? You never say never' - Harris
He has one of the toughest jobs in politics, but Health Minister Simon Harris understands the criticism, writes Donal Lynch
Simon Harris hurries along Dublin's Nassau Street on a summer's evening looking very much as if the weight of the world is on his shoulders.
In a way, it probably is. There can't be many heavier responsibilities in this life than the health ministry, combined with new fatherhood.
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But while his baby daughter merely sees to it that he lacks sleep, the endless scandals about the health system have at times threatened to derail his rise to the very top of Irish politics.
When he survived a vote of no confidence in the Dail last spring, the Taoiseach pointed to Harris's inarguable successes - in getting repeal of the Eighth Amendment over the line; in passing the Public Health Alcohol Act; in getting three national hospital projects under construction.
But the carousel of scandals - the latest being the gargantuan cost overrun of the Children's Hospital and the issues surrounding the treatment of the terminally ill Ruth Morrissey - have continued unabated.
Watching them unfold, you almost fear Health, after a briefly benign interlude for Leo Varadkar, would do for Harris what it did for Mary Harney and Michael Noonan.
The overall problem, Harris tells me, is that they did not get long enough in the job to see the political benefits of the pain they had to inflict.
"Health doesn't have the immediate gratification that other departments have," he says. "A lot of the things that really work in Health take a number of years to take effect.
"Mary Harney's work on the cancer strategy is saving lives now, but she got no benefits from that during her terms in office. Micheal Martin brought in the smoking ban when he was in Health and we're seeing the huge benefits of that now."
If that's the biggest political problem with Health, the biggest systemic problem is that the health service, to quote Harris himself "doesn't meet the needs of the country".
Simply put, we have too many people clogging up hospitals when they could be dealt with by GPs or in the community. To tackle this, a cross-party 10-year plan called Slaintecare, which aims to get patients out of hospitals and better integrate healthcare, has been agreed. Yet even this has been marred by contradictions and anomalies.
The reported €20m budget for Slaintecare seems paltry given its scope - Harris says in reality it's much more - and it is unclear how the new system will operate properly when public patients currently can get seen for free in hospital but have to pay to go to their GP.
"That's one of the contradictions in the Irish health service, but we're working on that," Harris explains. "We now have free GP care for kids under the age of six. Under the new GP agreement, that will be extended to children under 12. But you're right, it's not consistent at the moment - that you can turn up at hospital and not pay a fee."
Harris doesn't have to worry much about fees - he is privately insured. "I have insurance, like about 50pc of people in this country do," he says. "I'd like to get to a situation where I and those people don't need that, and under Slaintecare…"
So are those citizens in the public health system getting second-class care?
"There is a situation whereby people with private health insurance are able to get seen more quickly and that's why I'm committed to universal healthcare. I've said publicly that I want private practice removed from hospitals. I'll be bringing proposals to Government in September in this regard."
But is that not the ultimate evidence the system is broken, when the man in charge of it needs to go outside it?
"There's no doubt the fact that not just me but so many Irish people need private health insurance is a sign we're not yet where we need to be with regard to the health service."
But optics are important. How does he justify the fact the Ronald McDonald charity - McDonald's, effectively - will be involved in sponsoring the new Children's Hospital at a time we are in the midst of a childhood obesity epidemic?
"It's a charity that provides services at a lot of children's hospitals across the globe. It doesn't sit well with me that McDonald's is in the title but the work they do is sincere so, on balance, it's appropriate their involvement continues."
But where would we draw the line for sponsorship of a children's hospital? A cigarette company? Coca-Cola?
"I get the logic, I get the argument. I've campaigned to have a no-fry zone [no fast food being sold] around schools but, at the same time, the Ronald McDonald charity does a lot of good work."
Will he do something about it? "My priority is opening the Children's Hospital."
I mention the case of Ruth Morrissey, the terminally ill woman who took legal action after abnormalities were undetected in routine smear tests. The Government has said her €2.1m award will not be affected by the State's decision to appeal the case, but, at such a distressing time in her life, why did Morrissey have to learn of the appeal through the media?
"It's absolutely appalling, I can't answer that," Harris says. "It should not have happened."
Why would anyone want to work in the screening service when they come under such intense scrutiny from politicians and the judiciary? "Because they are saving lives every day. The morbidity rate for cervical cancer has declined hugely. We can eradicate cervical cancer in our country within a generation.
"[Workers in the screening service] have gone through a very difficult time in relation to this case. We have to protect people working in the health service. At the heart of the scandal was that the screening service decided to do an audit but didn't think it was a good idea to tell the women involved, and this caused mass confusion and the hurt and pain for women and families affected has been immense."
Is he concerned we are proven to be among the worst in Europe at reimbursing new and effective therapies?
"I am concerned, but people don't want tea and sympathy. We have a good record at getting drugs over the line but need to work on the length of time it takes to get approval. We need to work with other countries and share information with them. On July 2, we'll announce a joint scanning initiative with other countries."
Details from meetings of the HSE's drugs committee are not released or subject to Freedom of Information requests because of commercial sensitivity but, given the importance of their decisions, is this transparent enough?
"The HSE has to protect its ability to commercially negotiate and ultimately all the decisions have to go to the HSE leadership team," he says.
"It's not a political process because, if you look at the Pricing and Supply Act, the decision-making process is solely a matter for the HSE, which is not to shirk my overall responsibility for healthcare in Ireland."
The drug companies, with which the HSE has to negotiate, get a free ride from the media and public, he adds. "Ireland is picked on by Big Pharma."
Harris is both a party colleague of Maria Bailey and her second cousin. He says her 'compo' scandal may have impacted on the party, but not on him. I wonder if he has spoken to her since her car crash interview with Sean O'Rourke, which followed her ill-advised personal injury case against the Dean Hotel?
"I didn't," he says. "We saw each other in Leinster House and I may have said hello but we didn't speak about it all. At a human level I did feel sorry for her. Not to take away from the legitimacy of the story, but to go through a very intense period of scrutiny is going to take a toll on anyone."
Will she survive?
"I... I think we have to wait for the Taoiseach's report. My understanding is that she will be back very shortly. We'll have to wait and see."
In a decade, Harris has risen from Wicklow Co Council in Greystones, where he grew up, to a seat in Cabinet - at 27, he was one of the youngest ever to hold a ministry. There are times his star has survived even the slings and arrows of Health - he spoke inspiringly during the campaign to Repeal the Eighth - and is undoubtedly highly capable and articulate. A few years ago, he told an interviewer any politician who says they don't want to advance their career is lying. There isn't much further for him to climb on the Irish political ladder - does he want to be Taoiseach?
"You never say never. The comments I made in the Journal are true. I'm ambitious but being Taoiseach is not something for now."
Varadkar, he points out, "is the only person at the Cabinet table who knows what it is like to be Taoiseach and he's been extremely supportive".
He disputes the description of the people who showed up outside his Wicklow home last April as 'protesters'.
"The nurses protest. A mob turned up at my house and they were trying to intimidate my wife and baby. They issued a statement in support of the people who marched in military-style gear on O'Connell Street shortly after the murder of Lyra McKee. It was upsetting, my primary concern was for my wife and baby."
He smiles when I mention seeing him looking troubled as he leaves the department at night. "The hardest part of this job is that you can't just leave it behind you when you leave work. You're dealing with people who are depending on you and, while we can talk about reform and the future, there are so many cases that need something in the here and now. That takes an emotional toll with the job.
"But if I was a robot or a bureaucrat that would be even worse. People aren't laying the blame at my personal door, they're laying the blame at the door of the Minister for Health, and if I was a parent of a sick child, or a patient looking for help, I'd probably do the same."