Health portfolio a poisoned chalice for beleaguered Martin

NOBODY is asking who stitched up Mickey Martin, because everybody knows who did it. It was Bertie Ahern. “He’s the man,” as Charlie Haughey once said.

"He's the best, the most skilful, the most devious and the most cunning."

For a long time Martin looked the most likely to succeed Ahern. He had an unblemished record, a quiet Corkman, following in the shoes of Jack Lynch as Minister for Education. Prior to becoming Taoiseach, Lynch had achieved very little in the way of imaginative reform. He did away with the ban on married women teachers, but there was no opposition to that measure. His way was to be nice to everybody and cause a minimum of fuss and offence.

Martin did not show much initiative in education. He just played it safe. But then Bertie gave him the poison chalice of Health. That was where Michael Noonan committed political suicide. Most people would be hard pressed to name many Ministers for Health, because it has almost invariably been a dead-end job.

Noel Browne did make a name for himself in the post, but he got into bishop trouble and never got another Government job. There was, of course, one startling exception, the little fella from Kinsealy, who was appointed to the post by Jack Lynch in 1977.

Lynch chose to surround himself with an inner cabinet consisting of George Colley, Des O'Malley and Martin O'Donoghue. All of them despised Haughey, but if they thought they were going to bury him in the Department of Health, they were badly mistaken, because, unlike most of them, he had real administrative ability.

During his two-and-a-half years as Minister for Health, Haughey generated a considerable amount of publicity to enhance his own political image. He used his administrative and legislative experience to telling effect in securing funding for a wide range of programmes that for all his other failings he had the skill and drive to get off the ground. He also implemented some legislative measures that received enormous, if not always favourable, publicity.

"His greatest coup," according to the Irish Medical Times, "was bought for the modest expenditure of £1 million the cost of dramatically expanding the role of the new Health Education Bureau," which had been set up by his predecessor in 1975. Through the bureau Haughey launched imaginative publicity campaigns aimed at promoting better standards of fitness and hygiene.

He was credited with bombarding the public with exhortations to walk rather than drive, to jog, dance, play games, to quit smoking and to cut down on alcohol.

He introduced legislation to deal with the promotion and advertising of tobacco products. He banned cigarette companies from sponsoring a wide range of events and made it illegal for competitors in certain events to carry the name of a tobacco company, or its products. He had the imagination and drive to introduce legislation to ban tobacco advertising more than 20 years before the Americans or the British.

The groundwork had already been done for a new hospital programme by the previous government, but Haughey implemented the programme by cutting through reams of red tape. He took the design of Cork Regional Hospital and had it used for the Beaumont Hospital in Dublin, thereby speeding up the construction of the new building. He commissioned a new regional hospital in Wilton, Cork, secured funds for a £5 million development at Mullingar General Hospital, authorised an extension doubling the size of Sligo General Hospital, and got funds for a new general hospital in Tralee.

In July, 1978, Haughey announced a scheme providing for free hospitalisation for all those earning under £5,500 per year. His predecessor had been anxious to introduce free hospitalisation and the Department of Health had drawn up a scheme, but consultant doctors refused to implement it. Haughey compromised with the consultants and got Cabinet approval for the scheme.

This was a real political achievement, because free hospitalisation was not part of the 1977 election manifesto.

In November 1978, hundreds of uniformed nurses descended on Leinster House, looking for salary increases. Haughey has some 300 of them invited into the Dáil. Fine Gael proposed "to set up a commission of inquiry on nurses' pay and conditions" and Haughey stole the initiative by establishing such a commission of inquiry. By the time the nurses left Leinster House, they were being called "Charlie's Angeles".

He took on the bishops in forcing through the first law providing for the sale of artificial contraceptives in this country. Even if it was only "an Irish solution", it paved the way for others to pass amending legislation. A public opinion poll around this time found that Haughey had the most favourable rating in the Government, including the Taoiseach.

Some 75% thought Haughey had done well or very well in his ministry. On the other hand, George Colley, the man who would oppose him for the leadership later that year, had a dismal approval rating of just 38%, with 53% feeling that he was doing a poor job as Minister for Finance.

Haughey got elected Taoiseach as a result of his performance as Minister for Health.

One cynical commentator contended at the time that Haughey's plans were not for Health but to fulfil his own ambition of becoming Taoiseach. "What he's done," he said, "is to keep 10 balls in the air at the same time and protect his own."

Mickey Martin is obviously not a juggler. Doctors, nurses, hospital administrators, health boards and even medical card holders have all hit the target with their wide-ranging criticisms. He got savaged by representatives of the General Practitioners (GPs) who appeared on the high moral ground, even though the GPs are the ones who took millions of euro for treating ghost patients.

Last year members of the Government were bragging about how much they were spending on health, while the opposition was complaining that the Government was not spending enough. The eligibility for medical cards was extended to provide free medical care, free hospitalisation, free dental care, free dentures and free eyeglasses for the elderly. Once they get the medical card some people order extra dentures and eyeglasses, not because they need them, but because they are now entitled to a free set. They don't wear them, but they have them in case they lose or somebody steals the first set.

If there were even a nominal charge, it might eliminate much of the waste, as well as the money being squandered on political hacks on health boards. There are so many areas in which action is needed.

The case of the Chinese woman who was given a mask in Dublin and sent back to a hostel and then identified as a probable SARS sufferer, raises the most serious questions, especially when one realises that all 23 SARS deaths in Toronto can be traced to one Chinese doctor visiting Hong Kong. We were incredibly lucky that we did not have an outbreak in this country. Yet we have doctors who seem ready to hold the whole country to ransom in the face of a lethal disease.

What did they take the Hippocratic or hypocritical oath?