Don’t let politicians off the hook on HSE – they’ve been pathetic
FINE Gael has now been in office for more than seven years – it owns every single problem in the health service.
When James Reilly became health minister, after the February 2011 General Election, he had big plans. And he moved fast.
Within two months of Mr Reilly being appointed minister, the board of the HSE had fallen on its sword. All 12 members resigned voluntarily.
Welcoming the development, Mr Reilly said the changes he was making to the HSE were “an important part of the change agenda” and would “deliver the change we want to deliver, so patients get a better service”.
But, things didn’t work out like that. In fact, that was the only structural change Mr Reilly made to HSE – dismantling the board, and then forgetting to create anything else to put in its place.
In May 2017, the cross-party committee on the future of healthcare published its report, Sláintecare, and recommended the HSE board be resurrected. By November of last year, Taoiseach Leo Varadkar was presenting plans to re-establish the board as some kind of innovation of Health Minister Simon Harris.
“In terms of greater accountability on the HSE’s part, the minister has already announced his plans to establish a HSE board. There is no board for the HSE and we believe its creation would improve accountability.”
You almost have to admire the audacity. Fine Gael, having taken a wrecking ball to the HSE board in April 2011, has now, some seven years later, discovered what the HSE really needs – a new board!
Even better, it is presenting plans to reinstate the board as a reform from the minister, who is allegedly working tirelessly to put one in place.
So, when should we expect to see a new board at the helm of the HSE, improving accountability and corporate governance at the organisation?
The most recent update is that there should be a new board in place by January 2019 – and I’m sure we can rely on that timeline, as we all know this Government excels at hitting its targets.
In the context of the ongoing omnishambles that is the Irish health service, the issue of the board is a relatively minor one. But, the utterly incompetent manner in which this Government, and the last, has dealt with that one tiny issue – that one incidental reform – is instructive.
Most obviously, it tells us that they don’t know what they’re doing, but it also tells us that, despite all of the grand talk about change agendas, there is no plan and zero political will when it comes to actually reforming the HSE.
Oh, they’ll publish reports, and hold committee meetings and subject the management of the HSE to dogs abuse at every available opportunity, but don’t actually expect them to do anything other than pontificate and moan.
The structural reform that is required by the HSE cannot come from within. It must be directed by the Government. And it has abjectly failed on every metric.
Take the Sláintecare report. In the 12 months since that was published, what has happened? Nothing. Not a single change.
In fact, it took nearly eight months before the Government even advertised the position of executive director for the new programme office. And yes, you guessed it, that position has yet to be filled.
This is despite Mr Harris solemnly informing the Dáil in November 2017 that he understood “the need for urgency to be applied” to the recruitment process and “assuring her that urgency is being applied to this”.
So, forgive me if I get a bit jaded when I hear Government TDs loudly castigating HSE head Tony O’Brien for his abysmal tenure in office. Their own performance has been nothing short of pathetic.
Following the CervicalCheck scandal, Mr O’Brien has become a handy whipping boy for politicians. But, he has been publicly pointing out problems in the HSE for years and calling for political leadership to tackle them.
Most memorably, in an interview with the ‘Sunday Business Post’ in 2015, Mr O’Brien described the HSE as an “amorphous blob that nobody understood”.
He also, in that interview, noted it was “very difficult to forward plan in any meaningful way” when the budget is allocated on an annual basis.
In the UK, he said, NHS funding is allocated on a five-year basis, meaning managers “have a framework in which they can plan”.
Mr O’Brien is being hauled over the coals by politicians because, as the man in charge, the buck stops with him when there are scandals within the health service.
BUT, where is the accountability in the political system? Why are the same Government TDs who have been raging at Mr O’Brien not directing a similar level of anger at Mr Harris and the minister for health who preceded him, Mr Varadkar?
How is Mr O’Brien supposed to introduce structural reform to the health service when the Government refuses to tell him what those reforms should be; when it refuses to provide him with realistic multi-annual budgets?
According to Mr Harris, an implementation plan for the Sláintecare report will be published imminently – so, we should expect to see it within the next 12 months. Is Mr O’Brien supposed to be psychic? Is he supposed to be able to guess what it will contain?
The CervicalCheck scandal may well warrant the resignation of Mr O’Brien, but there is plenty of blame to go around – and those in Leinster House have, thus far, been let off the hook.
Mr O’Brien has been publicly pointing out problems in the HSE for years and calling for political leadership to tackle them