Her legacy is an organisation that cannot be described as fit for purpose. Sure, many parts of it appear to work pretty well but that is down to conscientious and professional staff. As an entity, it has been one huge and massively expensive disappointment.
Her successors as minister have not fared any better and that includes the current minister, Leo Varadkar, who appears to be at the helm but not in charge. Indeed, his job would appear to be, as Fine Gael poster boy and possible future leader, to ensure that a lid is kept on the department and its profile stays low.
The trick is for Leo to keep the department profile low while continuing to be seen as an effective minister and to maintain his personal profile while not actually doing very much to turn the HSE from dysfunctional monster into an effective health service.
It is some balancing act and, given the importance of an effective health service, is one that we can and should do without. Mind you, given the ongoing reports of dysfunction, Mr Varadkar’s job is not easy.
These days, it is almost impossible to pick up a newspaper without seeing some article or other about another failing by the HSE. Earlier this year, we had the reports of the failings of the HSE with respect to a hospital in Portlaoise where several infants died. Similar failings had occurred elsewhere in prior years, some of which were the subject of major expensive enquiries, but lessons did not seem to have been learned, and may even have been ignored.
In February this year, the HSE had to shelve plans to open a state-of-the-art psychiatric unit at Cork University Hospital (CUH) because of staffing and health and safety issues. On that occasion, the organisation went so far as to suspend an individual because he had spoken out, only to have to back-track later and reinstate him. It has now been announced that a staffing deal has been done — six months later.
In the last couple of days, we learned that a new €3m high-observation unit in the Kerry General Hospital in Tralee remained shut due to a nursing shortage. The unit was completed in December.
Last week, it was reported that €9m compensation had to be paid because of late payment of invoices. Earlier this week, we learned of yet another delay to the opening of the new cystic fibrosis (CF) unit in CUH. This time the delay is down to a lack of nursing staff, apparently.
To recap quickly, this unit was funded by the work of Build4Life, a CF charity. The management of the hospital declined to give any guarantees regarding the usage of the unit by CF sufferers. Build4Life decided to withhold the funds until they got necessary guarantees.
Now that the ward is built, it cannot open. Build4Life founder Joe Browne has noted that staffing has been on the agenda of the project group’s monthly meetings since January 2012.
In January of this year, it was reported that the INO repeatedly warned that Irish hospitals are already chronically understaffed in relation to nursing rosters. Mr Varadkar was well aware of it. Minister of state at the department of health and local TD Kathleen Lynch commented on it at the time. Have they solved the problem? Not on your nelly.
These are just some of the problems, replicated across the country. It is a disappointment to see this when we know there are tens of thousands of hard-working, effective, ‘coal-face’ HSE employees. What is needed is effective management.
Unfortunately, given that this does not appear to be possible under the present regime, the present HSE structures need to be redesigned and made fit for purpose. If there are people incapable, or not interested, in meeting these criteria they need to be retired. Most importantly, the vested interests which appear to hold sway in the HSE must be neutralised in all of our interests. There should be no more decisions based on political considerations. But then, can we really take at face value Mr Varadkar’s claim that he had no part in the decision to move the Rotunda to his constituency?