Politicians must hold health professionals to account

INSIDE POLITCS: Trying to make Mary Harney personally responsible for hospital failures could backfire on the Opposition, writes…

INSIDE POLITCS:Trying to make Mary Harney personally responsible for hospital failures could backfire on the Opposition, writes STEPHEN COLLINS

THE DEMAND by leading Opposition figures that Minister for Health Mary Harney should resign over the latest shambles at Tallaght hospital has raised the question about what exactly ministerial accountability means or should mean.

It was striking that during the often frenzied Dáil exchanges on the issue, the Minister was denounced in vituperative language by some of her political opponents for alleged failures at Tallaght but nobody demanded that the hospital consultants or administrators should be called to account.

A calmer atmosphere prevailed in the Seanad where Independent Senator Joe O’Toole rejected the simplistic notion of blaming the Minister. “It does not reflect malaise or apathy on her part that there were problems among medical staff, including clinicians, physicians, radiographers . . . It is time we had a debate on the difference between accountability, responsibility and related matters and on the role of a Minister.”

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O’Toole added that the role of the Minister was not to read X-rays or run hospitals but to ensure they were run as well as possible and if problems arose they were dealt with. Speaking from New Zealand, Harney tried to get a hearing for similar sentiments. “If a radiologist doesn’t report on X-rays in a hospital you cannot seriously believe that that is a matter that the Minister has direct personal responsibility for,” she said.

The fact that she was off on a two-week visit to the far side of the world for St Patrick’s Day certainly didn’t help Harney’s case. If Taoiseach Brian Cowen does respond to Opposition pressure and drop her from the Cabinet in the forthcoming reshuffle, her decision to travel for so long on such an expensive trip at a time when the country is in the throes of a deep economic crisis could well be the decisive factor.

Going on such a trip reflects a disconnect with reality arising from being too long in office but the same logic applies to most of the other leading members of the Government. They have simply been in power for so long, enjoying all the perks of office, that they do not understand how most people live.

That said, there is no genuine argument for suggesting Harney should be dropped over the problems at Tallaght hospital, the scale of which is still not clear. The Dáil rantings of some Opposition figures may well haunt them in years to come if, and when, they take responsibility for running the health service.

One of the most unedifying sights in politics is politicians trying to capitalise on the plight of ill or vulnerable people to get at a political opponent, usually the Minister for Health. During his time in what is probably the most difficult portfolio in government in the 1980s the then occupant of the office, Barry Desmond, described some of his critics as “shroud wavers” and the tradition lives on.

It has to be said that the current Opposition is still in the halfpenny place compared to Fianna Fáil when it was in Opposition. During the 1980s and again during the 1990s, Fianna Fáil behaved in an utterly irresponsible and cynical fashion on health. The character assassination of Michael Noonan as he attempted to deal with the Hepatitis C crisis in the best way he could was a demonstration of Opposition politics at its nastiest.

The problem is that as long as “shroud waving” continues to be used as a ploy, Opposition TDs will only demean the profession of politics and make their own future prospects of running the country in a rational manner all the more difficult.

It is quite legitimate to hold Mary Harney to account for her health policies. Fine Gael and Labour strenuously opposed her plans for co-location of new private hospitals on public land and they were perfectly within their rights to use every possible tactic to try and stop what they believed was a wrong policy pursued for ideological reasons.

The Opposition also opposed Harney when she took policy decisions that will stand to her credit long after she has left office and already reflect badly on their own pandering to local vested interests. Outstanding examples are her centralisation of cancer services in centres of excellence and nursing homes reform plan.

Whatever the merits or demerits of her policies, the Opposition was fully entitled to oppose them with all means at their disposal. They are also doing their job when they ask the Minister to account for what has gone wrong in the treatment of patients at various hospitals and to insist that procedures be put in place to ensure that mistakes or bad practices will not happen again.

However, it is not only unfair but counter- productive to blame the Minister personally for errors made by medical or administrative staff. Remember that Fine Gael and Labour fought the last election on health and lost, not because voters didn’t think the issue was important but because they realised that it was a complex problem not amenable to simple solutions.

In their own interests politicians should start holding the professionals to account for their mistakes instead of blaming each other. One of the reasons the country is in its current state is that we do not have a culture in which people at all levels are held responsible for their actions.

Instead, powerful groups like doctors, bankers, lawyers and senior public officials are fire-proofed against accountability by a professional/trade union culture where nobody can be blamed, never mind dismissed, for even the grossest dereliction of duty.

It is only politicians who have to go before the public to get reappointed but, in their scramble to blame each other as they climb the greasy pole, they don’t appear to see that by letting vested interests of all kind evade responsibility they are only heaping more grief on their own shoulders.