Primary care row obscures critical issue of budget

INSIDE POLITICS:Decisions that will affect the lives of every citizen for years to come are being taken behind closed doors

THE CAPACITY of the Irish political system to devote enormous energy to relatively minor controversies while the great issues on which the country's future depends are virtually ignored has been illustrated yet again by the latest storm at the Department of Health.

The selection of priority locations for primary care centres is important but it is far more complex than most of the commentary has acknowledged and it has as much to do with a personality clash between Róisín Shortall and James Reilly as anything else.

As revealed in yesterday's Irish Times, neither the priority list produced by Shortall nor the additions by Reilly bore much relation to the initial priority list produced by the officials of the Health Service Executive.

Shortall tripled the weighting initially attached to deprivation in order to get her top 20 and Reilly added another 15 locations to that list. Political lobbying certainly played a part in process and that is something that deserved to be exposed.

However, given the fact that the country is on the verge of one of the most significant budgets in the history of the State, it is quite remarkable that one small aspect of health policy is the subject of such intense debate while critical decisions that will affect the lives of every citizen for years to come are being taken behind closed doors.

In less than two months' time a €3.5 billion package of savings, made up of €2.25 billion in spending cuts and €1.25 billion in tax increases, is due to be unveiled by Minister for Finance Michael Noonan.

There have been ominous signs that the burden will fall disproportionately on the young and less politically powerful while groups such as public servants and pensioners will again have their interests protected, but we won't know for sure until the budget is unveiled on December 5th.

The debacle over failure to reform the allowances system in the public service does not inspire confidence in the Coalition's ability to get to grips with the some of the key issues at the heart of the crisis in the public finances but the very least that is required in advance of the budget is a full and open discussion about all of the available options.

For instance, reform of the current public service pension arrangements should be an urgent priority but it doesn't feature in political debate. The recent International Monetary Fund report on Ireland pointed out that the 53 per cent increase in pensioner numbers between 2008 and 2011 had seen the net public service pension bill jump by 49 per cent during the period. That offset by one-third the savings generated by the early retirement scheme.

"The need to rein in this burden (given population ageing) as well as equity considerations (the average public service pension is double the State pension) warrant a review of the scope for further savings in the pension bill," said the IMF.

One of the problems is that the politicians themselves have the most extraordinary pension provision of all. The State is paying out enormous pensions to former politicians, from retired presidents down, and until this is radically overhauled the Government will have no moral authority to curtail anybody else's entitlements.