ANALYSIS:Róisín Shortall is frustrated James Reilly has not consulted her on decisions in her area, writes MARTIN WALL
IT HAS been no secret for some time that there are tensions between Minister for Health James Reilly and Minister of State at his department Róisín Shortall.
Over the last year these differences have bubbled to the surface on a number of occasions. Sometimes this has come about as a result of the release of official correspondence between the pair or as in the case following the resignation of HSE chief executive Cathal Magee, after Shortall issued a statement pointedly asserting she had not been informed in advance by Reilly that he was departing and had only found out after it was revealed in The Irish Times.
Sources say the tensions stem not from any personal dislike between the two Ministers but rather that they share very differing views and philosophies on healthcare provision.
Shortall has pointed out that although she is Minister of State with responsibility for primary care, she has not been delegated statutory powers in this area by Reilly. It would appear that she has also been frustrated at not being consulted on decisions taken at the highest level in the department around dealing with the deteriorating budgetary situation even when this had implications for developments in her area.
The first indications of tensions emerged publicly last Christmas when The Irish Times published details of email correspondence between the pair. In an email to Reilly on October 21st, 2011, Shortall said he had refused four requests to speak to her about fees to be set for GPs administering the winter flu vaccine. Shortall also said it was “unacceptable” that she had been cut out of this process.
Shortall stressed she wanted “to express my entire dissatisfaction with the manner in which the issue of the winter flu vaccine fee for GPs is being handled”.
“I have tried to speak with you personally on several occasions over the past 48 hours. You refused each of these requests. You did arrange to speak with me by telephone this morning at 10am but I received no call.”
In March this year Reilly wrote a sharp letter to Shortall about the worsening situation regarding the handling of applications for medical cards.
At that stage more than 1,000 people had been waiting longer than six months. He wanted a report from her as soon as possible. She replied that there had been significant improvements in the backlog since she had made interventions.
By May this year the health service financial position was deteriorating. In a letter to Reilly she said she had urged the HSE primary care reimbursement service to make savings on inactive medical cards as soon as possible “because I will not be entertaining any cut in entitlement or introduction of user charges as proposed during the [budget] estimates/ comprehensive review of expenditure process last year”.
At the end of July, Reilly highlighted a significant budgetary overrun in Shortall’s area of responsibility and sought a clear report within one week on specific actions and timelines for dealing with this.
He raised the prospect of “time-related savings” – unspent money earmarked originally for specific Government initiatives such as the planned €20 million investment in primary care initiatives – being used.
On July 31st Shortall replied, stating it was difficult for her to engage with matters relating to the budget as she had no delegated statutory powers in respect of primary care or spending in this area, despite having sought them, and had “not been party to or been consulted on many of the decisions taken in relation to budgetary difficulties”.
She pointed to the failure to meet a commitment to secure €124 million in savings on drug costs. Shortall said she had offered to oversee negotiations with the pharmaceutical industry on these savings if she was given the necessary powers “but you stated that you intended to retain control over their negotiations”.
She expressed concern at lack of progress in meeting plans to appoint 300 primary care posts, extend free GP care and recruit mental health staff.
The tensions between the two became even more obvious on Wednesday night in the Dáil when Shortall expressed concern at lack of progress on health service reform.