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