HSE still controlled by vested interests

Tuesday’s editorial argued that the Government’s credibility had been undermined once again.

However, the real truth of the matter is that Government credibility has been shot to shreds by a myriad of other failures and not simply by the hypocrisy of ministers in taking pay increases or in giving them to their advisors.

Indeed, the taxpayers of this little country of ours could be forgiven for thinking that there is nobody at the helm and the ship of state is running aground — once again.

The way the Department of Health and the HSE are run once again came into sharp relief over the last week, highlighting the dysfunctional nature of both organisations.

Unfortunately, it’s not as if any of this stuff is new. The health service was known as Angola under Brian Cowen, and it’s only deteriorated since then.

The Department of Health appointed Cathal Magee to take charge of the HSE less than two years ago and he resigned recently in apparent frustration at the failure of his dealings with both the minister and the senior department officials. He had taken on a very tough job — one where a myriad of vested interests hold sway and guard their own individual territory with apparent disregard for the patients.

As he had previously worked in the private sector, his knowledge of the Byzantine ways of the public sector might not have been as good as they could have been. However, public sector managers had been tried before and the result was the unmitigated disaster that now exists — despite the efforts of the tens of thousands of hard-working and conscientious staff in the system.

Mr Magee had apparently being given his terms of reference and advised of the limit of his authority. This included the fact that several major critical issues including the global medicine cost reduction negotiations remained the remit of the civil service.

He also apparently wrote to the department and asked for its guidance and support, when he noted that costs were spiralling and the budget was being exceeded and was, it is reported, told to just get on with his job as directed by the minister.

However, part of his remit included working within his allocated budget. However, this required action by the department in order to reduce the prices we pay the manufacturers for drugs. It’s a classic Catch-22 situation — tell you to do something but refuse to give you the tools to do it, and then blame you when it is not done.

It has now transpired that the department had indeed negotiated with the manufacturers of generic drugs. In the rest of Europe, there is apparently a 40% to 60% saving on off-patented by using generic drugs. However, in Ireland, we are now advised that the department agreed the generic drug manufacturers could charge up to 98% of the cost of the patented drugs. It’s barmy at best.

We should not forget brand-name patented drugs justify their high price by citing the many billions spent in research and development. That is why they are given extended patents so that they can, it is argued, recover their R&D costs and make some profit. They do the later handsomely as we all know.

However, the generic drugs that replace the patented drugs have no such R&D costs. So why should the department agree such a deal? Arguing that the price charged is justified by different Irish packaging simply takes us all for gullible fools.

Fine Gael has stated it intends to break up the HSE. If it is to do so, it needs to do it properly and not allow vested interests to continue to control it for their own benefit. It needs to be manageable and fit for purpose — it is not a case of simply moving the chairs on the deck of the Titanic.



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