Point-scoring in Dáil will not improve health service

InsidePolitics:The ugly side of adversarial politics is the way human tragedy and suffering is often used for political gain. Even worse is the way such events are exploited in pursuit of power or money.

In recent days Minister for Health Mary Harney and Taoiseach Bertie Ahern have been unjustly excoriated by political opponents and vested interests over something for which they are quite clearly not responsible.

The misdiagnosis of women with breast cancer at the Midland Regional Hospital in Portlaoise has had tragic human consequences.

The fact of the matter, though, is that neither the Taoiseach nor the Minister were in any way responsible for the failure to diagnose the women properly. Yet to listen to the Dáil exchanges on the subject on Wednesday, it would appear that it was their fault and theirs alone.

It was not even as if it was a policy decision by the Minister or the Government that had led to the misdiagnosis of patients at Portlaoise.

In fact in policy terms Harney and the Health Service Executive have been fighting a ferocious battle against an array of forces to try and close small and outdated cancer treatment centres to provide vastly improved treatment at a smaller number of centres of excellence.

That policy does entail serious problems for people living in remote areas but, while that is something that has not yet been addressed properly, it is another issue. The Taoiseach lost his cool in the face of the goading he endured in the Dáil and that expression of frayed nerves generated a further day of headline news.

The Opposition may well have scored in the purely political objective of damaging the Government but, in the process, the options facing the country in terms of providing the best type of cancer treatment for the Irish people have been hopelessly obscured.

It was always thus in Irish politics. It is more than 20 years since the then minister for health Barry Desmond urged the public not to be deceived by "the shroud wavers in opposition" exploiting the fears of vulnerable people.

"Healthcare needs money and some deliverers of the health services, particularly some members of the medical profession with a specialised interest, will indulge in any amount of scaremongering to gain more money for themselves, generally on the backs of the taxpayers," he told the Dáil amid roars of derision from Fianna Fáil back in 1985.

That is why sympathy for Ahern and Harney for being blamed in the wrong has to be tempered somewhat by the fact that in opposition their parties behaved as badly, if not worse, than their current opponents.

One of the most unfair political campaigns ever waged was that which destroyed the political credibility of Fine Gael's Michael Noonan, when he was minister for health in the rainbow government.

Noonan was savaged by Fianna Fáil and the PDs over the hepatitis C controversy and politically he never recovered. Nobody remembers now that the compensation scheme he introduced for women infected with the hepatitis C virus was the most generous of its kind in the world.

All that is remembered is that, goaded by the current parties of government and influential people in the legal profession, he uttered intemperate remarks about some of those campaigning against him.

Fianna Fáil and the PDs narrowly wrested power from the rainbow government in 1997 and the margin was so small that the hepatitis C controversy may well have played a vital role. The two parties have now been in power for the 10 most prosperous years in the nation's history but, in the belated attempt to reform the health service, they are now coming up against the combination of a strong, confident Opposition and powerful outside interests that faced Noonan just over a decade ago.

Senator Eoghan Harris hit the nail on the head during a debate on the issue in the Seanad. "The consultants continually block reforms. There are vested interests in trade unions in the health services. There are hospitals in which managers cannot take decisions because they are afraid of the unions.

"As every European report has pointed out, the health services are a nest of vested interests. What we need is a proper debate on health services that points the finger at the people at whom it should be pointed - the consultants and the vested interests who are delaying reforms."

The Opposition may well be able to damage the Government with an indiscriminate attack on its health policy. The danger is that political point-scoring may simply perpetuate the evasion of reality that has allowed the health service to get into its present state. As a country we are spending a lot of money on health and, while there have undoubtedly been real improvements across a whole range of services over the past decade, big problem areas still remain.

A genuine debate is needed so that some of the fundamental structural changes required in the system can be introduced in a fair and coherent manner.

It has been remarked that a Tallaght strategy for health, with a consensus between Government and Opposition on key elements of the strategy, is probably the only way to deal with the issues involved. If the politicians could present a common front, it would certainly make it easier to defeat the vested interests who are fighting their own corner rather than the common good.

The problem is that there is not much incentive for the Opposition parties to engage in a consensus approach to health. The Tallaght strategy effectively did for the then Fine Gael leader, Alan Dukes, and it paved the way for Fianna Fáil to win the five succeeding elections.

The lesson from Fianna Fáil's ruthlessly aggressive and partisan opposition between 1995 and 1997 is that putting the common good first doesn't pay.

However, the Opposition parties should consider whether it might even be in their own long-term interest to help get health service reform moving in the right direction over the next few years. After all, their obsessive emphasis on health did not win them the recent election.

In any case there are a range of other issues which the Opposition could exploit to expose Government arrogance and ineptitude.

The flight from reality displayed by the astonishing pay award to the Taoiseach and his Ministers, the failure to reform an increasingly well- paid and protected public service and increasing signs of chickens coming home to roost in the economy are just some of them. The Government is vulnerable over things for which it truly is responsible.