HSE re­form plans: The more things change the more they stay the same

Wicklow People (West Edition) - - OPINION -

SO here we are again. It’s Ground­hog Day in Le­in­ster House and the Depart­ment of Health. Nine years af­ter Fine Gael first promised to abol­ish the HSE, the Gov­ern­ment look to be rolling out the same pro­posal once again as they bid to re­cover some of the po­lit­i­cal ground they have lost in ru­ral Ire­land.

The heath ser­vice re­mains one of the peren­nial cri­sis zones in Ir­ish pub­lic life – Brian Cowen mem­o­rably de­scribed the Depart­ment of Health as An­gola be­cause of all the po­lit­i­cal land­mines that lay in wait – and while the faces have changed the prob­lems re­main the same.

Back in 2011 the HSE was just as un­wieldy and un­fit for pur­pose as it is now.

In the face of pub­lic fury with Fianna Fáil over their dis­as­trous han­dling of the econ­omy, Fine Gael were surfing a wave of pop­u­lar­ity that saw them win 76 seats in the Dáil and take power in coali­tion with Labour.

A key plank of the Fine Gael cam­paign had been its pledge to get rid of the HSE and re­place it with a more cost ef­fi­cient and far less bloated health ser­vice.

The elec­tion pledge won Fine Gael many new fans and a huge num­ber of votes but af­ter Enda Kenny took power it was largely for­got­ten

While Health Min­is­ter James Reilly – who had pro­posed re­plac­ing the HSE with a health ser­vice model based on a Uni­ver­sal Health In­sur­ance – man­aged a few to­ken re­forms, over­all not much changed.

Fast for­ward four years and in late 2015, with Fine Gael again fac­ing into an­other elec­tion, the idea resur­faced. This time it was the then Health Min­is­ter Leo Varad­kar who an­nounced that he was plan­ning to dis­man­tle the HSE over the next five years. As we have seen that didn’t happen ei­ther.

Now, as Fianna Fáil show real signs of recovery and Mr Varad­kar’s Fine Gael stare down the bar­rel of a dif­fi­cult elec­tion – par­tic­u­larly in ru­ral Ire­land – the no­tion of purg­ing the HSE has resur­faced once again.

Health Min­is­ter Si­mon Har­ris – who has been rocked by sev­eral of Cowen’s land­mines in­clud­ing the Cer­vi­cal Check scan­dal and the enormous cost over­runs at the Na­tional Chil­dren’s Hos­pi­tal – is the lat­est Fine Gael Health Min­is­ter to roll out a plan to wind up the wildly un­pop­u­lar HSE.

His pro­posal? Es­sen­tially he wants to bring back the health boards which, be­fore they were dis­solved in 2005, were seen as in­ef­fi­cient, parochial fief­doms that prevented the operation of a stream­lined health ser­vice.

We’re told that the new health board sys­tem – of which we have been pro­vided with lit­tle de­tail – will be more cost ef­fi­cient, will bet­ter serve lo­cal needs and will cut down on job du­pli­ca­tion.

That’s all well and good – if it happens – but given the litany of fail­ures and bro­ken prom­ises we have seen in the health ser­vice , how can vot­ers be con­fi­dent that this time will be any dif­fer­ent?

Min­is­ter Har­ris’ in­ten­tions do seem noble but vot­ers would be for­given for tak­ing a wait and see ap­proach. Fool me once…

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