Tuesday 23 April 2019

Gerard O'Regan: 'Nigh impossible challenges of health service should not be used as political football'

How the State assesses tenders for work to be carried out on its behalf is of key concern. Stock photo: PA
How the State assesses tenders for work to be carried out on its behalf is of key concern. Stock photo: PA

Gerard O'Regan

We've had another ritual round of national hysteria fuelled by the ill-informed - this time about the National Children's Hospital. As usual with whatever happens to be the health crisis of the moment, politicians are riding a high horse, or on their favourite bandwagon.

Sinn Féin could luxuriate in the most trite and pointless of all options. A no-confidence vote with no chance of success. This is the all too convenient comfort blanket for those who wish to be judge and jury regardless of evidence still to be heard.

We had much posturing on all sides in the Dáil. Yet we still don't know the answer to the central question in this whole affair. Are we getting value for money for the work involved - despite the budgeted cost of the hospital rocketing? Put simply: were original estimates so out of kilter, they would not have provided a 'world-class' structure and facilities?

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Circumstances may have combined to confront us with a singular option. Stay within the original and agreed budget, but accept it would give us something inferior to what the hospital could, or should, be. However, given this is a generational opportunity, it is surely not a situation to be penny wise, pound foolish.

Amid the cacophony came a more general aside from Ciarán Devane, chairman of the Health Service Executive (HSE). He fears Ireland could be bankrupted if we "throw lots of money at healthcare and it doesn't deliver".

Of course, there are many unanswered questions regarding the children's hospital project. How the State assesses tenders for work to be carried out on its behalf is of key concern. Trying to get a job done at the cheapest rate, and at the same time ensuring it is of optimum standard, is always a challenge.

In an intriguing RTÉ interview with Marian Finucane, former HSE chief Tony O'Brien spoke of pressure on public servants to accept the lowest tender on offer. He raised a crucial issue.

Those dealing with taxpayers' money are expected to always look for a bargain. But cheap is not always best. Going for the low-cost option carries a risk of having to stump up more cash to ensure a finished product is to the standard required.

The probe into the children's hospital must investigate thoroughly the tendering process. Were prices agreed with various contractors and suppliers, fine-combed by those charged with getting value for every euro spent? Who knew what, when, and how, must be clarified beyond doubt.

Overall, the events of recent days are surely proof positive that the challenges of our health service are way beyond the capabilities of a single minister - or a particular government. As this hospital funding crisis gathered pace, the nurses' strike threatened to cripple the entire system. All the while 'routine' issues, ranging from the cervical smear controversy to hospital waiting lists, hovered in the background.

It's wishful thinking and it's not going to happen. But it's time there was some agreement between the main parties - say for a five-year period - that health no longer be regarded as a political football.

And there's no point in Simon Harris pretending - unlike sundry others who have done his job - he can single-handedly cope with the intractable problems that come with it.

Equally, Opposition parties suggesting that nice, neat solutions will fix matters touching on life and death has become a nauseous charade.

The Sláintecare 10-year plan is touted as a beacon of light. But it contains nigh impossible challenges. As things stand, it will flounder in a political morass.

There is irony that it was Barry Cowen who backed Mr Harris into a corner on the hospital funding saga.

His family know first-hand the travails of being health minister. Brother Brian famously compared it to trying to sort out a notoriously unstable African country.

No doubt when Brian and Barry are having a chinwag down in Offaly, the advice of the former to the latter would be to avoid this ministry at all costs, should it come his way.

The way things stand that sure makes sense.

Irish Independent

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