Health in crisis - A culture that simply must change

PUBLIC debate has been dominated for quite some time by two issues and there is no indication that the agenda will change anytime soon.

The tribunal at Dublin Castle, especially the Taoiseach’s drip-drip, incredible testimony, and the malaise undermining our health system have dominated headlines and political debate. Each is a negative.

One gravely undermining the political system and encouraging the cynicism so destructive to a positive and energetic society. The other undermining confidence in the State’s ability to manage our resources to provide an acceptable health service to everyone, irrespective of their resources.

On each issue there are too many unanswered questions and too many unaccepted responsibilities. Too many uncertainties festering away in the heart of our society, just too many divisive issues distracting from far bigger and far more pressing questions.

This week, on publication of multiple reports — why so many? — on the Portlaoise cancer scandal, Health Minister Mary Harney and the Health Service Executive chief executive Professor Brendan Drumm apologised to nine women who had wrongly been given a clean sheet and who were later found to have cancer.

Minister Harney’s acceptance of responsibility is as it should be but it would be more reassuring if it was matched by the kind of action that would follow a similar crisis in sectors not insulated by public service employment culture.

If the minister accepts responsibility she has a responsibility to act and if that means confronting personnel issues then so be it. If she won’t do her job how can she, or us, expect those answerable to her to do theirs?

The latest skirmishes include the disappearance of letters warning of the likelihood of a cancer crisis at Portlaoise years before it happened; a HSE directive to a woman in her 80s that she should weigh used incontinence pads to establish if she was entitled to a better grade of pad; and the reluctance of the HSE to accept responsibility for the procedure that requires a one-legged man to repeatedly fill in forms to confirm that he is still entitled to the relevant support. As if he might secretly grow a new leg and defraud the State by continuing to claim the benefits.

Considerable credit must go to broadcaster Barbara Power and Newstalk Radio for the campaign they are waging to establish HSE accountability.

Despite repeated efforts to get answers from the HSE — a public service funded by your taxes — she has yet to succeed.

As late as yesterday a member of staff in the HSE press office hung up live on air because Ms Power had “not sought their consent to go on live radio”. This is a person paid out of public funds to answer questions. A job for life and a bomb-proof pension, but no answers.

The thought processes, the disconnect and the commitment to the notion of public duty in the HSE is illustrated by their response to the campaign.

They have stopped sending the station ordinary, common-garden press releases, thereby hindering the station’s news service. They, in your name, have also threatened punishment where it hurts most, in the advertising budget, suggesting that if Ms Power’s campaign continues that Newstalk will not get HSE advertising.

Some HSE bright spark might have though that that represented playing hardball with a bolshie mediaorganisation but it would be more accurately characterised as blackmail. Blackmail and two fingers to the notion of accountability from a public organisation.

Is it any wonder the health service is the way it is?