STATE’S FETISH FOR SECRECY
The culture of HSE is also the culture of Leinster House
THE State has a fetish for secrecy. Rather than a presumption of openness, the political and civil service elites have always operated on a presumption of secrecy unless disclosure turns out to be absolutely unavoidable.
We saw this over the past two weeks with the cervical smear controversy. Consumed by a form of collective chaos and amnesia, everyone demands accountability, no one gets it, and politics eventually returns to normal. This is no way to run a country.
The airwaves and the Dáil chamber have been full this week with rightful praise for the indomitable Vicky Phelan, whose courage and bravery in the face of unyielding bureaucracy have shone a light on the black box of secrecy.
Those same voices have castigated the State for standing by and not doing enough for citizens like Mrs Phelan. We have former government ministers bemoaning the culture of secrecy that has plagued the State – seemingly without realising that they were part of that culture. The current Government is inflicted with a type of amnesia over what it can and cannot actually do.
This sclerosis reached bizarre heights on Wednesday with an extraordinary interview on RTE’s Drivetime by Social Protection Minister Regina Doherty, who outdid herself with moral outrage on the harm done to Mrs Phelan and the women of Ireland.
YET Doherty had no answer when the host Mary Wilson rightly pointed out to her that it was Fine Gael who voted against mandatory open disclosure, which would have forced doctors to tell patients about their mistakes. (It changed a key section to make the requirement voluntary rather than mandatory.) Instead, Doherty relied on that oldfashioned idea that the change came from the bureaucracy.
This is a defence that Leo Varadkar has also relied upon. Legislation to compel doctors and hospitals to own up to mistakes was first mooted by the Taoiseach when he was minister for health. However, he has said that he moved away from the proposal on the recommendation of officials.
By backing down on that legislation, he has been forced to endure his worst week since becoming Taoiseach. His plaintive remarks on Friday that a culture change was needed within the health service is astonishingly brazen for a man who served as health minister.
Secrecy, Irish-style, leads almost invariably to sub-optimal policy outcomes, while there is increasing global evidence that open government and transparency is actually the key to efficient and effective government. This is the case with the cervical screening controversy. Varadkar is at least right when he says that the heart of the issue was a failure of open disclosure by senior management.
Secrecy in essence erodes public trust in government and in democracy, while the lack of trust in representative democracy presents major challenges to politics and to citizen engagement. At its heart, open government is about increasing the ability of citizens, business and civil society organisations to collectively influence public decision-making, thereby improving it for all citizens.
There are numerous problems with Government decisionmaking. Each quarter, the Comptroller and Auditor General publicises examples of enormous waste and inefficient decision-making by ministers and departments as well as public sector bodies. In addition, there is ample evidence that decisionmaking on Government spending is skewed towards allocations to ministers’ constituencies. Decisions are often made in an ad-hoc manner based on hunch and anecdotal evidence or on partisan grounds. All this is enormously wasteful.
Two of the most significant decisions taking by public representatives in the history of the State – the bank guarantee scheme and the bailout – were made in secrecy. There was a constant insistence from politicians that neither was going to happen until it actually did.
THE bank guarantee scheme in 2008 had all the attributes of making it up as you go along. A policy decision was taken by the then Fianna Fáil-led government to guarantee all the deposits and obligations of the commercial banks without knowing the cost of their liabilities.
The easiest decision was to let the State take responsibility, and it was the one ultimately plumped for by the taoiseach of the day, Brian Cowen. It had all the hallmarks of a let’s-hopefor-the-best mentality that has characterised public policy and decision-making since independence. A decade later, we are still living with the consequences of that decision.
If the bank guarantee decision reeked of a lack of intellectual rigour and a haphazard approach to policy-making, the move to seek a bailout in 2010 showed the problem with secrecy in policy-making.
Senior members of that government, including Cowen, insisted up to the proverbial 11th hour that the country would not seek aid from the EU or the IMF, while that same government’s finance minister, Brian Lenihan, was negotiating an aid deal. It took the intervention of a public servant, the governor of the Central Bank Patrick Honohan, ringing RTÉ’s Morning Ireland – to say that the government would indeed be entering an EU/IMF programme to receive substantial financial assistance from the IMF in the region of tens of billions of euro – for the truth to come out.
ONE of the big disconnects in Irish political life is that the general public has lost faith in the political process. There are two reasons at work here. One is that the public feels politicians break their promises and, two, is that the public has no real idea of what politicians actually do in their name.
The bank guarantee scheme and bailout are classic examples of this genre.
This is also the reason why outraged demands from politicians this week that someone needs to be held accountable for the cervical smear scandal are met with weary shrugs from the public. No one can really take them seriously, as politicians themselves are lamentably rarely held to account.
The goal for the State should be to ensure that all Government decisions and data are open, with those responsible for decisions held accountable for them. This must hold for all levels of governance and for all public bodies.
As it is now, the State is inflicted with the curse of non-responsibility. On the cervical cancer story, there was a year-long exchange over who would tell the women. No one wanted to take responsibility. The State fought the cases in court and sought confidentiality clauses. The culture of secrecy was all pervasive.
Calls for openness and transparency are all fine in theory but unless those who have responsibility take responsibility and admit it openly, then little will change. It’s not just the HSE and the Department of Health that need a culture change, as was the mantra from politicians this week.
We need a new culture where the overriding goal of politicians is to serve the citizens, and not themselves in their quest to be re-elected. Civil servants need to work for the citizens, not the system. Until that happens, we will see the usual pattern: everyone demands accountability, no one gets it and politics eventually returns to normal.
And then another Vicky Phelan scandal emerges.
Accountability should happen in the HSE, the Garda and the civil service… but it also needs to happen in Leinster House.
Given that it doesn’t really happen there, it is hard to consider the outraged and shrill demands for accountability that were howled from the political class this week as anything more than mere political posturing.