Tuesday 25 June 2019

Lowry could show naive Halligan a thing or two about getting things done

John Halligan TD outside Leinster House. Photo: Gareth Chaney Collins
John Halligan TD outside Leinster House. Photo: Gareth Chaney Collins
Colette Browne

Colette Browne

John Halligan is being pilloried for doing what politicians have done for decades - using ministerial power to direct additional investment into their own constituencies.

The level of sanctimonious criticism of Halligan's refusal to accept the findings of an independent expert review of cardiac services at University Hospital Waterford (UHW) coming from the political establishment, is quite hard to stomach.

Suddenly, TDs from every political party are fans of using clinical reviews of services from medical experts to determine health policy. Or, at least, that's what they'd have you believe.

In reality, all of this moralising is just self-serving guff and the big mistake Halligan has made is not fighting tooth-and-nail for his local hospital, but rather being too open and honest about it.

Let me explain. Halligan secured the review of cardiac services at UHW as a reward for agreeing to join the Government. But, the first TD to agree to prop up this minority Fine Gael Government was actually Tipperary's Michael Lowry.

Having been around the block a number of times, Lowry is a shrewd politician. He knows how things work and how to get things done. Instead of making a big song and dance in the national media about the goodies he had received in return for his support, he would only say he had "come to an agreement with Fine Gael".

He definitely wasn't naive enough to have any promises that were made to him included in black-and-white in the Programme for Government and made contingent on an expert review that he had no control over.

While mystery surrounds the agreement Lowry reached with his former party, last month there was a surprise announcement that Lowry's local hospital was getting a massive investment - a 40-bed 'patient hotel' and funding for an additional 10 nurses and 10 healthcare assistants.

This patient hotel, a modular step-down facility that will be dropped into a site at the back of South Tipperary General Hospital, is the first of its kind in Ireland, potentially a game-changer when it comes to tackling the trolley crisis nationally.

However, I'm unaware of any independent expert review recommending that this novel way to tackle A&E overcrowding should be trialled in Tipperary. Instead, FOI documents released to a Sunday newspaper indicate the decision was made after Lowry had a number of private meetings with Health Minister Simon Harris.

To put the investment Lowry has secured for his local hospital in context, the much-vaunted HSE winter initiative will see 55 extra acute beds provided at just five hospitals around the country. Meanwhile, Lowry has secured 40 en-suite step-down beds for South Tipperary General Hospital, thereby freeing up the same number of acute beds in that hospital. Not a bad day's work for the Tipperary TD.

While Halligan has become the poster boy for parish-pump politics, since he kicked up a stink about the results of the review of UHW, Lowry's deal has barely received any scrutiny. Certainly, no one in Fine Gael has had the gall to give the Tipperary TD public lectures about the importance of evidence-based decision-making, unlike the condescending treatment that has been meted out to Halligan.

If you think Halligan and Lowry are the only TDs looking after their local hospitals in Leinster House, the horrified reaction to a leaked report into national trauma services should be instructive.

An expert group, the Trauma Steering Panel, has been tasked with coming up with a national policy for trauma care. Much to the horror of some politicians, it has recommended that nine hospitals around the country, out of the 26 that currently deal with these cases, no longer treat emergency trauma patients. The reason? Centralising services will save lives, they say.

Fianna Fáil leader Micheál Martin was so appalled at the leaked report that he recently raised the matter in the Dáil at Leaders' Questions, querying a model of healthcare "driven incessantly by medics" and wondering why a "common sense" approach could not be adapted instead.

Coincidentally, the Mercy Hospital in Martin's local constituency is one of the hospitals the steering panel has in its crosshairs.

Another hospital that would no longer treat emergency trauma patients, if the review panel has its way, is Wexford General Hospital.

Speaking to his local paper, the 'Wexford Echo', Minister of State Paul Kehoe sought to assure his constituents the Government "was in no way obligated to accept or implement any of the findings contained within this report".

In contrast, when asked about the ongoing controversy in relation to Halligan and his refusal to accept the findings of a different report, Kehoe told RTÉ: "We cannot have politicians running hospitals across the country."

Why is the Waterford TD expected to suck up the findings of an expert review into services at WGH when other politicians, in the Government and the opposition benches, clearly have no intention of adhering to the recommendations of other expert reports that affect their own local areas?

Perhaps some day we will have a health system where services and investment are provided on purely clinical and evidence-based grounds.

However, that day is not here yet, even if the outraged reaction to Halligan's parochialism suggests otherwise.

If the Waterford TD fails to deliver a second cath lab for UHW, it won't be because 'New Politics' has succeeded. It will be because he was foolish enough to have a back-room deal included in a public document and made contingent on an independent review.

The next time he is doing a deal to enter Government, he won't be so naive.

Irish Independent

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