Don’t tinker with HSE: just tear it down
WE ALL are familiar with the names of Brigid McCole, Susie Long, Vicky Phelan, Róisín Molloy and Rebecca O’Malley. These names are synonymous with tragedy, tied inextricably by a series of catastrophic failings in our health service.
The pattern is the same. First, their concerns are dismissed. More often than not, they are dragged into court to receive justice and recognition that would have cost far less – in financial terms to the HSE, and in emotional terms to the women – if anyone had stood up and said, yes, we made a mistake, and we will endeavour to do everything we can to atone for it and ensure it never happens to anyone else.
More often than not, the women even have to fight just for full disclosure of the facts, as an attempt to protect institutions takes precedence over natural justice.
This all is allowed to happen because of the politicisation of the HSE. Not only is it convenient for senior politicians to have a separate entity to blame when things go very badly wrong, but the HSE also often has its hands tied when it becomes a football in local politics. Attempts to establish regional centres of excellence have been undermined by politicians whose platforms amount to little more than keeping the local hospital or A&E open, even when better care could be provided centrally.
It also means that at the likes of the Oireachtas Public Accounts Committee, TDs and senators get to grandstand when they have scant knowledge of the issues. At the committee this week, ex-HSE boss Tony O’Brien was grilled by people with little or no medical expertise, and was asked the same questions several times.
While the focus of the CervicalCheck scandal must remain for now on the women affected, we can’t lose sight of the fact that there was a cover-up. Why do agents and institutions of state prioritise protecting the organisation over the needs and rights of the citizen?
Too often, the entire framework of the HSE is at the whim of whoever is health minister. Dr James Reilly promised universal health care, until it was deemed to be too expensive to implement. He removed the independent board of the HSE, a board current health minister Simon Harris now wants to resurrect.
We must get off this self-indulgent merry-go-round and immediately make fixes, such as accelerating the introduction of HPV screening on top of the existing smear test programme, after examining other countries’ approaches to implement best international practice.
Piecemeal tinkering with individual aspects of the services provided under the HSE is not enough, and it does not abrogate the need for radical change.
As a young country, we had a real chance to build it on principles of community, of caring and of compassion, with the citizen at the centre. Instead, we got sucked down the rabbit hole of self-preservation and the protection of the institutions of state ahead of those they were meant to serve.
That must stop, and for it to stop, here is a good start. Wouldn’t it be a fitting tribute if the next government were elected on a platform that promised to tear down the irreparably broken HSE and give us a health service we deserve?