Harney leaves a mixed legacy in healthcare

IT’S no secret that when Mary Harney accepted the health portfolio in 2004, other ministries had been discussed.

“Many people might have said ‘my goodness, are you mad?’,” Ms Harney said in an interview with the Irish Examiner last year.

“I just said ‘no, health’... you get stuck in there and there’s a good reform programme, that remains the situation today.”

Those were Ms Harney’s words last June. Seven months on, she has detached herself from what many regard as the toughest portfolio of all after a final few months marred by attacks on person and property.

Ms Harney’s arrival in office preceded the arrival in January 2005 of the Health Service Executive, which many saw as little more than a ploy to rid the minister of day-to-day responsibility for running the health service. Her “policy only” approach has been constantly criticised during her tenure.

Her failure to end the problem of trolleys in overcrowded emergency departments despite a €70 million 10-point plan outlined in the 2005 estimates will be a lasting legacy. Last week, the Irish Nurses and Midwives Organisation counted 569 patients on trolleys, an all-time high.

Ms Harney also leaves office without realising one of her pet projects. More than five-and-a-half years after she announced co-location as a “fast and cost-effective” way to provide additional beds in the hospital system, not a single co-located hospital has been built.

Ms Harney had many battles with frontline health staff, not least nurses, who engaged in 44 days of strike action prior to her re-election as health minister in 2007. In May 2006, the Irish Nurses Organisation unanimously passed a motion of no confidence in Ms Harney. However, they do acknowledge her support in the introduction of nurse prescribers.

She also did battle with consultants with whom she agreed a lucrative new contract. It meant an extended working week and greater availability at the weekends but it came at substantial cost to the public purse.

Some of the heaviest criticism levelled at the minister came on foot of several cancer misdiagnosis scandals. She was also lambasted for withdrawing automatic entitlement to a medical card for the over 70s and for investing so heavily in the National Treatment Purchase Fund when public hospitals were starved of cash.

To her credit, she invested heavily in improving patient safety, not least through the establishment of the Health Information and Quality Authority to carry out inspections of nursing homes and children’s care homes. This will be extended to the licensing of acute hospitals in 2012.

The creation of “centres of excellence” for cancer care is another welcome legacy. So too is the establishment of “Fair Deal”, a process that should allow every citizen of the state access nursing home care.

Ms Harney said she enjoyed her portfolio “from a different perspective”. Her life will acquire a very different perspective now she has decided to step down.