Plenty plans just no political leadership

TOM Keane is a man to whom anybody who gives a fig about the country should listen, says Michael Clifford.

This is what he said last Tuesday: “Our existing system has pockets of excellence, but until we address the many systemic problems caused by a lack of process and transparency, we will remain anchored in the past.”

What was he talking about? The scandals in the gardaí? The scandal in housing? No, he was referring to the scandal of our health service, but what he was saying is as applicable to the other two. And when somebody like Tom Keane says that, there is good reason to pay attention.

Mr Keane is one of the few exceptions to the rules that govern how things tend to be done in this country. He fought the system and won. A decade ago, as director of the National Cancer Control Programme, he oversaw the development of centres of excellence across the State. The outcome has been a significant improvement in cancer care. There are more people alive, extracting better quality from their lives, because of the work of Tom Keane.

This country does have a record in producing individuals who do excellent work for the public service. The difference with Mr Keane was that he had to fight the system to drag his project over the line.

There was serious opposition to his plan that saw care concentrated in eight centres. Smaller centres had to close. The opposition was particularly vocal in Sligo, where people in the North-West, understandably, felt cancer care should be retained in the town for reasons of geography.

Keane held the line. The philosophy of centres of excellence is based on the premise that a large throughput increases expertise which in turn improves outcomes for everybody. In the end, despite serious political pressure, Sligo lost the battle.

The development was a rare example of the right thing being done despite serious political opposition that placed short-term votes ahead of the long-term health of the whole State.

How did he do it?

He told RTÉ radio last week: “The reasons are many. But those most prominent are a well-designed, evidence-based plan; strong clinical leadership; excellent communication; and, perhaps most important of all, strong and sustained political support.”

He might have added that as the person driving the plan, he was something of an outsider — while he is from Ireland, he has spent most of his working life in Canada.

Tom Keane

His point about political leadership is also interesting. Mary Harney was minister for health at the time and she backed him to the hilt, despite serious opposition from various localised and vested interests.

Few who have any interest in social justice miss the PDs on the political stage. But Harney can take credit for her leadership in the development of cancer care. There is copious evidence that many who preceded and succeeded her would have caved-in to the pressure; demanded that Keane adjust his plan; quietly ensure that the long-term was slipped onto the long finger, or at least beyond the next election.

Irish public life is littered with examples of “well-designed, evidence-based plans” for the common good which died on the rock of political expediency. The Buchanan plan to develop rural Ireland, published in 1970, was an excellent document. If it had been implemented, rural Ireland would look very different now.

Instead, rural Ireland is going through a slow, painful death, as successive governments apply sticking plasters here and there, root around for flighty votes, and make redundant noises.

The Kenny Report into rezoning land published in 1973 was immediately shelved. It proposed restricting the value of rezoned land to the agricultural value plus 25%. If implemented, it could have ensured that the common good got precedence over vested interests in planning, but there was no political stomach to take on the land-owning lobby.

In 2001, environment minister Noel Dempsey brought in a provision that 20% of new housing developments had to be set aside for social and affordable housing. His successor, Martin Cullen watered it down completely the following year at the behest of builders. Would we now have a housing crisis — or have gone through a building bubble to the same extent — if that sensible measure had been retained?

Having a plan has never been the problem. Implementation has. Keane said during the week that previous reports which recommended reform for the health service were not implemented. The real problem has largely been leadership, and particularly political leadership — somebody with the balls to do the right thing because it’s the right thing to do.

So it goes in health and housing. So it goes in An Garda Síochána. The Government’s answer to the latest scandal in the gardaí is to order another plan... report... review — call it what you will. This cynical move is typical of the political cowardice that has informed oversight of the force since the 1970s.

The “well-designed, evidence-based plan” is already written in 14 reports, some of them excellent, compiled over the last few years. The Government’s proposal has nothing to do with the gardaí, and everything to do with long-fingering painful change.

Leadership is the big issue and that has been missing from both the organisation and political overseers. Look at one small example. As part of recent reforms, smaller Garda stations, most in existence since the 19th century, were shut down. The commissioner selected the stations to go based on evidence.

Along comes newly-minted government minister, Shane Ross, with his insistence that his local station in Stepaside, Co Dublin, be reopened. A review was set with the stated purpose of selecting six of the closed stations to reopen. And some would say the whole exercise was done to give cover to Ross in having Stepaside reopened — the reopening is due to be confirmed later this month.

Unfortunately, reconfiguring stations is a miniscule problem in the gardaí compared to the really big stuff that has emerged in recent weeks and months. But the example does illustrate how politics trumps reform unless there is sufficient leadership to do the right thing.

The current garda commissioner, even if she was intent on serious reform, has been weakened by a succession of scandals — some corporate, some associated with her personally. The day has passed when she could have grasped the authority to drive through real change.

Just as Keane was an outsider in developing cancer care, the time is now here when an outsider is needed to reform An Garda Síochána.

Even if that leap is made, the bigger question of political leadership still remains. Does the current or any prospective minister for justice care enough to ensure we have a functioning police service, whatever the political cost?