Health system is incapable of being honest with itself

Even Varadkar and Harris admit being unable to trust what HSE officials told them

The director general of the HSE Tony O’Brien appears before the Oireachtas Health committee over the CervicalCheck controversy.

 

The turmoil in Government and the health service continued to escalate on Wednesday, with Dáil exchanges dominated by the controversy and Opposition clamour – though Fianna Fáil remained largely silent – for the resignation of HSE chief Tony O’Brien growing.

Not surprisingly, perhaps, women deputies were especially angry about the screening scandal. Mary Lou McDonald demanded O’Brien’s head in plain terms:

“If the Taoiseach is serious about providing leadership on this matter and reassuring women across the State, he would do the first thing that needs to happen – to remove that incompetent man from the position he holds.”

The Taoiseach, in response, sought to talk not to McDonald, or even the House, but to the watching public.

Later, when O’Brien appeared for several hours at the Oireachtas health committee, he was faced by a cross-party coalition of angry women – Louise O’Reilly, Kate O’Connell, Senator Rose Conway-Walsh, Ruth Coppinger and Bríd Smith. There was more than just politics going on here.

O’Brien brought 10 officials with him as a defensive phalanx; he could have used 10 more. The TDs didn’t believe him; and they thought he should resign.

But O’Brien cut a dogged and determined figure, saying he intended to use his remaining three months in the job to tackle the cervical screening scandal. With inquiries on the way, that may largely be out of his hands now, but he was not for moving on Wednesday. O’Brien has a reputation as a wily political fighter; but he must also have the hide of a rhinoceros.

The truth is that as long as he remains in his post, he will be the focus for Opposition and media attention. For now, the HSE chief is a sort of political human shield for the Government.

Just as importantly in the current political landscape, Fianna Fáil is not minded to push for a head either.

The affair has shown us an extreme dysfunction in the management of a vital public service, and its oversight by elected politicians. By their own admission, neither the Taoiseach nor the Minister for Health could trust what they were being told by senior HSE officials.

Users of the health service have long known that parts of it – usually the bit where you get in to access the service – are utterly dysfunctional. It now seems that the health system – right across its political, administrative and service aspects – is incapable of being honest with itself. It requires statutory inquiries to do that.

Given that we are supposedly on the verge of a major reform of the health system – the long-awaited Sláintecare implementation plan is imminent – this does not exactly bode well for the future. How can a system that lies constantly to itself be fixed?

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