Friday 22 November 2019

Brendan Keenan: Doctor in the house but State is still ailing

Wise men and women in government who limit their own power may be the only way we dodge another meltdown

THE naked power of government ministers was on full view last week, although no one seemed very embarrassed about it. It is, after all, what we are used to seeing in our daily papers.

We are also used to things being done badly. More and more, the secret of economic success is seen as good governance. Neither stimulus nor austerity -- depending on your preferences -- are of any long-term use if the system itself is dysfunctional.

Dr James Reilly's air of brusque superiority may remind many of their own GPs -- but what matter if the correct treatment is prescribed? But even though doctors may be government ministers, government ministers are not doctors.

In Ireland, though, their relationship with the public they serve is more like that between doctor and supplicant patient than it ought to be.

I take no sides in the dispute over the best criteria for primary health care centres. To me, the most interesting thing to come out of the furore was Dr Reilly's explanation of how he came to devise the final policy.

This process involved his personal consultations with his officials and some people who know a bit about it, added to his own experience in healthcare. And, lo, a policy was born.

Admittedly, it is an improvement on Eamon de Valera's consultations with his own heart, but it is in the same sorry tradition.

There is no shortage of genuine evidence-based analyses of the health system. The main ones, such as the Brennan report on management and the Hanly report on hospitals, were prepared when the world was young and Bertie Ahern led a reforming government.

The reforms petered out under the two great guiding principles for which Mr Ahern was always the standard-bearer: no strikes in the public sector, and no upsetting marginal constituencies (which, under our voting system, means pretty much all of them).

Phil Hogan's diversions were a normal part of constituency massaging, and were stoutly defended as such by the minister. The Minister for the Environment, that is, which also raises the issue of power.

The last thing which occurs to anyone is that ministers should take a break from such lobbying; on the grounds that their enormous powers make it almost certain that decisions will be overturned purely to meet the minister's wishes.

The extent of those powers came up via another, different issue -- the cost of certain mobile phone services, which appears to be 40 per cent above the EU average.

There is a regulator for the sector, ComReg, but it is the classic Irish regulator -- severely limited by its terms of reference and subject to the overweening powers of its minister.

Those powers are pretty standard in Irish legislation. "The minister may give such policy directions to the Commission as he or she considers appropriate to be followed by the Commission in the exercise of its functions. The Commission shall comply with any such direction," it says.

In fairness, the directions cannot apply to individuals but otherwise the position is clear. ComReg cannot do anything which would upset the minister and must do what the minister thinks is important enough to merit a direction.

Most, if not all, Irish policy quangos, regulators and investigative bodies are little more than facades. Judge Peter Kelly thinks it even applies to the judicial appointments board.

This is how we seem to want it. If ministers ever do suggest that the state of this or that is a matter for a designated body, the result is howls of outrage. The idea that power might be dispersed, and something like the HSE acts of its own accord, under a separate system of scrutiny and accountability, is simply unthinkable.

None of this matters unless you think it might have something to do with our present sorry state. Circumstantial evidence suggests that it does. The strongest bit is that this is the second national bankruptcy in 30 years. That smacks of carelessness.

Another appeared in a recent ESRI research paper. Apart from a couple of sane years in the Nineties, Irish government policy has been "pro-cyclical" for all of those three decades -- either fanning booms or intensifying busts.

The first is caused by politics taking precedence over everything else: the second is a direct consequence of the first.

Unless some way is found to distribute power more widely, there is every reason to suppose that it will happen again -- and, in the meantime, that resources will be widely mis-allocated.

The philosopher Plato could not explain where he would find the wise men who would govern his ideal state. Experience since seems to show the best results come from the paradox of competing sources of power jockeying for their own advantage.

One might hope for wise men and women in government who would accept that the Irish system is deeply flawed and set about reducing their own power in the interests of the country as a whole. Like Plato, we have yet to find them.

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