Former junior minister Roisin Shortall has warned the Fine Gael/Labour Coalition: "This is not over." In a candid interview on the Marian Finucane Show yesterday, she spoke in detail on the crisis that led to her dramatic resignation
'There was a situation developing over a number of months where I felt Minister for Health Dr James Reilly wasn't following the Programme for Government.
"I was engaged in a whole lot of work that was blocked in the summer months. Then I question why I would stay in the Department of Health. What is the point of doing that if you boss is not supporting you?
"It's a hugely sensitive department because it's about life and death.
"Cathal Magee [the former HSE chief executive] had been writing on a weekly basis that we were not going to come in on target because the minister didn't do what he had promised to do.
"Dr Reilly is moving towards the American model, moving towards the insurance companies running the health service.
"I was determined that we did strengthen primary health care. I managed to get a special allocation of €20m for nurses, etc. I was determined that this would be spent on frontline services.
"There is a tendency to portray this as a squabble between two people -- and because it is a man and a woman, it feeds that a bit. The reality is it had been coming ... there was a view he wouldn't be around in the longer term ...
"I had considered it [resignation] in July. I had to make the call. I had serious concerns about his ability to manage the health service. I firmly believe he is going for American model, down the private route.
"There wasn't one thing -- this had been coming for a long time. I had been delighted to appointed minister of State in March last year. I'd been given a really challenging job. It wasn't the usual junior minister job, it was given a very specific agenda of reform.
"I had to make a number of judgement calls in recent months. There was a situation developing over a number of months where it was quite clear that James Reilly and I weren't on the same page. I don't believe he really prescribes to the Programme for Government. There were fundamental differences.
"It was the lead-up to that, lots of work had been blocked [by the senior minister]. At that point I started to questions why would I stay in the Department of Health having put in all that work. If you boss doesn't support you, if you've done a whole lot of work with a whole lot of other people over several months to bring something to fruition -- and it ends up blocked. What's the point in doing that if your boss is not supporting you in doing that?
"This was part of the concern I had as well, the way the department was being managed financially. You can tackle the unacceptable drugs bill -- we are paying far too much for drugs -- or you can cut home health services.
"You can tackle consultants' pay and put a cap on pay or, you know, you put a charge on people's medical cards.
"There are all kinds of choices there. James Reilly did sign up to a health budget that could have been balanced this year if he had followed through on the commitments he'd give to tackle those big-ticket items within health -- insurance costs, drugs costs, consultants pay, all of those kind of things. The budget is predicated on him doing that, but he hasn't and now we are coming to the end of the year and we are facing the most appalling cuts because of his failure to tackle those issues.
"From November last year, I had been in touch with the Tanaiste's office because I would have had concerns that it wasn't possible for me to sort out the differences in the department. There is that relationship, a senior minister, what he or she says goes and I except that.
"Health policy is really important to the Labour Party. We had a very big input into the Programme for Government of the health policy.
"I had a task and I realised that it was going to be difficult to address the differences within the department. So I contacted the Tanaiste's office, and I would have been in touch with his staff over a number of months updating them and briefing them on what the issues were, looking for ways of addressing those.
"They weren't really resolved and things came to a head in July where a lot of the work that had been done ran into the sand.
"I had set all that out for Eamon Gilmore, the policy differences that were very obvious at that stage and the specific instances of work I had been doing in primary care area that he wasn't prepared to support. I set that out and would have had discussions with Eamon Gilmore about this. I would have said to him: 'I need help on this, I'm doing this on behalf of the Labour Party. It's a two-party Government, I can't resolve this from within the department, I'm overruled. Officials take their direction from the senior minister, obviously, and we need to deal with this. It's a bigger issue than a Department of Health issue, it's a cross-government issues.'"
"He suggested we sit down with the Taoiseach and James Reilly and set out on paper what those concerns were. We had that meeting and it really didn't resolve anything, we didn't get anywhere. I suppose there was a view that you should just go off on holiday and take a rest. There was no resolution and we came back in September and nothing had changed. I really had to say: 'Why am I staying here, why am I pretending that I am the minister for primary care when I wasn't?
"I'll work with whoever I have to work with, that's what politics is about. You get on with the business of doing what you're supposed to be doing. I didn't mind for a moment if James Reilly took credit for any of this, I was determined to implement the reforms. It wasn't a personality thing.
"That was why I was so keen to actually set it out that this is about a policy.
"No one likes giving up and I am quite determined. I have been in politics quite a long time and really wanted to implement the stuff in primary care and the alcohol stuff. I thought about it very long and hard and it was difficult decision but the reality was it was coming for a couple of months. I tried to hold on in July when it was difficult. There was a view that James Reilly wouldn't be around in the longer term because there are other issues there.
"People need to face up to what is happening in the health service. The failure to reform and the serious difficulties.
"I had to make a call on this when the confidence motion came up. I had serious differences with James Reilly and I had serious concerns about his ability to manage the health service, and his ability to implement the reforms, or his interest in implementing the reforms. I believed he was going an entirely different direction down the whole privatisation, American-style route, and I still firmly believe that. So it came to confidence vote and my inclination was to vote 'No'.
"After the speech my path didn't cross with any the ministers in the immediate aftermath. Then last Friday afternoon, yesterday week, I met with Eamon Gilmore and we discussed it again. I reiterated that this is not something that can be resolved within the Department of Health. It needs to be resolved by the parties in Government. And he said he would consider that. The same message that I had been relaying to him over a long period.
"The whole controversy had broken in relation to the selection of sites for primary care.
"He said he supported James Reilly and ultimately he backed James Reilly over me."
Edited extract of Roisin Shortall's interview with Marian Finucane on RTE Radio yesterday