Cheap and cyn­i­cal to blame med­i­cal staff

The Irish Mail on Sunday - - COMMENT -

WHEN po­ten­tial pa­tients were count­ing the num­ber of shop­ping days to Christ­mas last week, the Taoiseach pan­icked about the hos­pi­tal trol­ley count in Jan­uary. But his call for front­line med­i­cal staff to can­cel hol­i­day leave and deal with chaos in A&Es had more to do with me­dia man­age­ment than pa­tient care.

Does he re­ally be­lieve that blam­ing it on the med­i­cal staff in early Novem­ber will di­vert pub­lic anger from his gov­ern­ment when scenes of suf­fer­ing pen­sion­ers are on tele­vi­sion in pan­tomime sea­son?

No doubt his over-pen­sioned and un­der­whelm­ing min­is­ters think the Taoiseach’s cun­ning plan is in­spired. But his grace­less at­tempt to shift re­spon­si­bil­ity to med­i­cal pro­fes­sion­als is as cheap as it is cyn­i­cal.

There are many self-serv­ing anom­alies that ben­e­fit con­sul­tants and other hos­pi­tal staff but the man ul­ti­mately re­spon­si­ble for the health ser­vice should not be seek­ing scape­goats with stetho­scopes.

Leo Varad­kar was Min­is­ter for Health from July 2014 un­til May 2016 and knew about the an­nual win­ter cri­sis in emer­gency depart­ments then – just as the rest of us have known for years.

Trol­ley grid­lock on hos­pi­tal cor­ri­dors is now as Christ­massy as Jin­gle Bells – and min­is­te­rial hand­wring­ing on New Year’s Eve as sea­sonal as Auld Lang Syne.

The three Ms – men, money and ma­chin­ery – were the an­swer to most ques­tions since the in­dus­trial revo­lu­tion but legacy prob­lems in the Ir­ish health ser­vice need an­other M – man­age­ment.

The man­age­ment of the health ser­vice has the money, cur­rently €17bn-a-year, to fund it. The Lancet med­i­cal jour­nal even quoted the Taoiseach’s grum­ble that if we pay the fifth high­est amount of money per head on health, we should ex­pect the fifth best health ser­vice.

SO OUR health ser­vice is more than ad­e­quately funded – but what is ur­gently needed is lead­er­ship, courage and per­se­ver­ance. Back in 2005, politi­cians came up with a dev­il­ishly cun­ning plan: the HSE. It would pull to­gether the old district health boards and man­age them un­der the HSE logo while the Min­is­ter for Health handed down pol­icy.

And it came with an­other enor­mous bonus for the gov­ern­ment – the HSE as a whip­ping boy. Mid­dle man­agers ab­sorbed the blame that used to be heaped on the Min­is­ter for Health and re­mained anony­mous when the coun­try de­manded some­one be held re­spon­si­ble. That self-serv­ing pro­to­col was laid bare last week.

In an ex­tra­or­di­nary in­ter­view, the now in­fa­mous for­mer head of the HSE, Tony O’Brien, ex­posed the brazen ca­reerism and ego­tism of gov­ern­ment min­is­ters. He dumped on the in­cum­bent Si­mon Har­ris yet praised the Taoiseach with whom he served for two years.

Min­is­ters aban­doned poli­cies at the first rip­ple of pub­lic un­ease and made hand­brake turns when tough de­ci­sions needed to be made. Ex­pert re­ports that made sound med­i­cal sense for the pub­lic were binned if they threat­ened to em­bar­rass politi­cians.

Tony O’Brien had to go af­ter the Cer­vi­cal Check scan­dal but he did the State some ser­vice. And last week’s in­ter­view sug­gests he and his ilk took the rap for many prob­lems that were ag­gra­vated by politi­cians.

O’Brien spoke well of Mary Har­ney who ac­tu­ally asked to be ap­pointed Min­is­ter for Health and whose can­cer care strat­egy with Dr Tom Keane was, and is, a re­sound­ing suc­cess.

It is worth not­ing that Mary Har­ney was al­ready think­ing of re­tir­ing be­fore mov­ing to the de­part­ment of health and do­ing the right thing.

And what­ever else it is, blam­ing the med­i­cal staff for the sham­bles in the health ser­vice is not the right thing for a Taoiseach to do – par­tic­u­larly a med­i­cal doc­tor and for­mer Min­is­ter for Health.

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