THIS WEEK'S decision by both of Fianna Fáil's TDs in Sligo-North Leitrim to resign the party whip operates as a timely reminder of the political potency of health as an issue. While economic concerns now dominate our politics, health hasn't gone away, writes
NOEL WHELAN
Government Ministers had prepared themselves for the prospect that individual spending cuts might precipitate backbench defections in the autumn. They had also expected the nationwide strike by pharmacists to generate political and media stress over the holiday season. Few, however, would have predicted that localised concerns about cancer services at a particular hospital would have precipitated the biggest political story of August.
Over recent months both Eamon Scanlon and Jimmy Devins had made known their unhappiness with the decision to transfer breast cancer treatment services from Sligo to Galway but their decision to resign the party whip and to do so on the day the transfer was implemented appears curious.
Those of us looking at this week’s events from outside can only guess at the intensity which this particular issue has generated in the Sligo-Leitrim area. But many of their parliamentary colleagues believe that if the two deputies got themselves in a position where they felt, at this stage of the process, they had no alternative than to resign the party whip then they only have themselves to blame.
Many find it difficult to fathom why Scanlon and Devins think they will be able to insulate themselves from whatever local political consequences flow from the transfer of services by resigning at this stage and resigning the party whip rather than from the party itself.
Political controversies about the rationalisation of hospitals and the concentration of key services to specialist centres are not new. The large number of independents elected to the Dáil in the 2002 election was testimony to the importance which localised concern about hospitals plays in political contests. The annals of recent electoral history document the rapid rise and subsequent disappearance of many independent “hospital” TDs. Such has been the fate, for example, of Paddy McHugh of Ballinasloe, James Breen of Ennis and Paudge Connolly of Monaghan.
While this week’s resignations do not make the Government’s task of framing next year’s budget any easier it is worth noting that the issue on which Scanlon and Devins resigned predates our current economic crisis. The decision to move breast cancer diagnosis from Sligo to Galway was made several years ago. Transferring cancer services from Sligo to Galway is not a question of money but a question of implementing best practice in cancer treatment.
Over the last decade a series of reports and investigations into our cancer services recommended a greater concentration and specialisation of services. The expert medical consensus is that delivering cancer treatment in larger hospitals where a greater number of cancer patients are treated by multi-disciplinary specialised teams increases detection and recovery rates. Acting on this overwhelming medical opinion the Government decided on the centres of excellence strategy.
On behalf of the taxpayer the Government has invested considerable resources in achieving this reconfiguration of our cancer services. It also managed to persuade Tom Keane, the Irish born professor who had done similar work in Canada, to take on the task of overseeing its implementation.
Keane and his team, along with the HSE, have been extraordinarily successful in rolling out the strategy notwithstanding the changed financial context and the resistance they have faced from some in the system.
As this process has unfolded many Government deputies have had to wear the political consequences of downgrading or transferring services from their local hospital. It is not easy to persuade voters that local is not always best or that centralised services can deliver better outcomes.
Localised political or medical sensitivities have had to be sacrificed in the interest of improved care and improved rates of cure. There is no reason why Sligo should be detached from that reality.
It is not clear what outcome Scanlon and Devins expected to achieve from their meeting with Brian Cowen last week. Even if he were personally so inclined there is no way in which the Taoiseach could have set about altering the decision about cancer services in Sligo without undermining not only his own authority but also that of Prof Keane and the Minister for Health Mary Harney.
Another leader in another time might have been tempted to fudge the issue or throw money at some interim solution but those days are over. The money isn’t there for such political extravagances. This Taoiseach’s political make-up is also different. The decision about cancer services in Sligo is made and cannot be reversed.
The attention has moved to the implications which Scanlon and Devins’s now semi-detached status has for the Government’s working majority in the Dáil. While of themselves these resignations from the party whip present no immediate difficulties, they have, however, occurred at a time when the Government majority is already tight, when the Green Party is suffering its own traumas after the local elections and when the Government faces decisions of an order not faced by a government in more than a generation.
All of these decisions will be politically unpalatable and many of them will present particular localised difficulties for individual Fianna Fáil backbenchers who will not thank their former Sligo colleagues for this week’s antics.
