Cabinet wants end to tit-for-tat spats between ministers over health budget
Plan for external ‘referee’ to act as peacemaker on funding levels
THE Cabinet wants the ‘tit-for-tat’ war between Health Minister Stephen Donnelly and Public Expenditure Minister Paschal Donohoe to end amid growing concerns the public feud is damaging the Coalition.
It comes after our sister newspaper, the Irish Daily Mail, on Friday revealed Mr Donohoe described spending overruns at Mr Donnelly’s department as ‘appalling’.
Mr Donohoe, whose department oversees Government spending, also told officials before the Budget that health spending presents ‘a material and significant risk to our public finances’.
Documents also showed the Fine Gael minister was scathing of his Fianna Fáil Cabinet colleague’s management of the health department, which he described as ‘extremely frustrating’.
However, senior Department of Health sources hit back this weekend.
One source told the Irish Mail on Sunday: ‘We are in the middle of trying to turn the direction of the biggest oil tanker in the country.
‘It takes time and it takes blood, sweat and tears, but it is happening. There is not an appreciation of this at the Department of Public Expenditure.’
However, senior Coalition figures have called for an end to the inter-departmental feud. One Cabinet source told the MoS: ‘There must be an end to the tit-for-tat war, we understand that. DPER [Department of Public Expenditure and Reform] are correct to call out what they see as a failure to provide productivity.’
In response, senior Department of Health sources said the two departments need to agree a ‘baseline’ level of funding.
One source suggested that a new Future of Healthcare body, with an external group co-operating with the Department of Public Expenditure and the Department of Health, could improve relations.
‘The Department [of Health] and the HSE are on the same page on funding now, which wasn’t historically the case,’ the source said.
‘The tensions are between Health and DPER now… That’s the fault line.
‘What this comes down to, is [agreeing] the correct amount of money to fund the health service, and how do we break this cycle of underfunding every year, followed by beating the HSE up for spending money they have to spend, or we don’t treat patients, which nobody will contemplate.
‘So how do we fix that? What the Minister for Health will do is set up a Future of Healthcare study. He will bring in an external group – or “referee” – to do this and he will invite the Department of Public Expenditure to sit on it. This will establish the baseline.’
Revelations in the MoS in the aftermath of the budget which described the breakdown in relations between the ministers – including details of an acrimonious meeting in which Mr Donnelly told Mr Donohoe he was ‘insane’ not to grant the health department extra funding – caused consternation within Government.
At the tense pre-budget meeting, Mr Donnelly told his Cabinet colleague: ‘What you are proposing is insane… You’re proposing that we stop progressing all of the health services, the cancer strategy, the maternity strategies, stroke, diabetes, genetics, trauma. It just goes on and on and on.
‘You understand we’re going to have to bring in hiring freezes across the entire health service now. Like, do you understand, first of all, the implications of your position for patients?’ he asked.
A Department of Health source said of the exchanges last night: ‘Listen, we understand, that’s an articulation of a position we were aware of. We do think it’s strange that they would release briefing notes for the minister.
‘But the Department of Public Expenditure repeatedly underfunds Health. That’s a fact. And then they blame Health for overspending.’
Health sources said this position is backed by the Economic and Social Research Institute and Ireland’s budgetary watchdog, the Irish Fiscal Advisory Council.
One senior Government source accused the DPER of ‘setting Health up to fail’. They said: ‘It’s a cycle. A lot of what was said last week was, “Health was overspending, this is terrible”. But that’s only a credible position if you give them enough money in the first place.’
One minister pointed out that there have traditionally been tensions between Health and DPER; the former tries to maintain or improve services, while the latter strives to cut costs.
But they added: ‘The problem with this tit-for-tat battle between the Department of Health and DPER now is that, whereas there was always tension, it was constructive. Now it is destructive.’
‘It takes time and it takes blood, sweat and tears’
‘They repeatedly underfund Health’