Varadkar is just what the doctor ordered for Department of Health
This health minister is the envy of his colleagues for his ability to communicate with the punters, when people are so sour with the Government. That “direct line” to the voters has been much in evidence over the past few days.
The minister made two major policy announcements at the start of this week: One a significant policy U-turn; and the other the delaying of a major policy initiative. Yet there was hardly a whisper of criticism.
That Varadkar will not now be disbanding the HSE seemed almost a throwaway remark in a newspaper piece he wrote on Monday. He also confirmed that the Government’s grand plan to introduce universal health insurance (UHI) by 2019 was “too ambitious”.
Any other politician would have brought wrath and ridicule down on his head with such news, but Varadkar’s little bit of magic means that he was asked his thoughts and plans, rather than criticised for his decisions. Ministers and advisers in other departments were left scratching their heads in wonder, once again, at his ability to connect. It’s only a few weeks since the health minister said politicians needed to trust the electorate more, and to tell them things as they are, and he’s starting as he means to go on in the Department of Health.
That this Government pledged both to introduce universal healthcare by 2019 and abolish the HSE was bonkers. The surprise is that it took this long for that to be acknowledged. This was a plan to tackle the root and branch of a system, but also the trunk — ultimately, the results, if the plan had progressed according to deadline, would have been disastrous. The HSE abolishment proposal was never more than window dressing by former health minister James Reilly.
The big surprise would have been if Varadkar had announced that universal health insurance was going ahead.
One of Reilly’s bigger problems was his struggle to explain how his system would work. This week, I spoke with someone who worked in the Department of Health. She remembers going to a department briefing on UHI, not long after Dr Reilly was appointed minister, and coming away from it confused. At lunch, she asked a more senior colleague, “who is really very bright and he didn’t understand it either”. We all know “the money will follow the patient” catchphrase, not to mention the examples of the “Dutch model” and the “German model”, but just how it might exactly work for us here always seemed a little hazy.
It makes far more sense to begin with universal GP care and primary care before moving on to the bigger picture. That will start with the under-6s and pensioners over 70, before being expanded; and then you can look at UHI.
It is a relief to think that our health services are in such seemingly competent hands and, while, as Varadkar says himself, miracles cannot be performed in the space of 18 months, this health minister could well set in train a strong process for improving the delivery of healthcare in this country and the morale of those deliver it.
Varadkar has the ear of the electorate and so is the envy of his colleagues, but he has never had political responsibility as large as the health portfolio before, nor the weight of such expectation. It’s not that long ago since he could be relied on to be “lippy Leo” — remember the minister who said we’d need a second bailout, or his cheap shots in the Dáil at former taoiseach Garret FitzGerald?
In a 2010 interview, he was asked about his views on allowing abortion following rape (he’s against it). But he was also asked if there was a double standard in 5,000 women travelling from Ireland to Britain for abortions every year. His answer was typically flippant and disrespectful. “People travel overseas to do things overseas that aren’t legal in Ireland all the time. You know, are we going to stop people going to Las Vegas? Are we going to stop people going to Amsterdam? There are things that are illegal in Ireland and we don’t prevent people from travelling overseas to avail of them.”
But, to be fair, he does appear to have matured politically. His intervention on the whistleblowers’ controversy — he thanked garda whistleblowers, Sgt Maurice McCabe and John Wilson, and said their behaviour was better described as distinguished not disgusting — certainly cemented his relationship with the public as a straight-talker who could be trusted, even if some of his colleagues felt he’d been disloyal with those remarks and their timing.
Reilly’s reputation as health minister had become almost cartoonishly bad. He didn’t help himself but, by the end, it wouldn’t have mattered if he’d found a cure for cancer.
As a result, everything floundered and his colleagues parasitically took advantage of the situation rather than look at the comprehensive picture of a failing service that needed all hands on deck if it was to be brought around.
There was a telling incident, just after the Cabinet reshuffle, between Varadkar and Labour Minister for Public Expenditure, Brendan Howlin. There had been newspaper headlines that the new health minister was laying it on the line to the man in charge of the purse strings, regarding the budget for the Department of Health next year.
But Howlin subsequently told a journalist that he’d received a text from his Cabinet colleague that Sunday morning to assure him that neither he, nor his people, had been the source of that story.
It’s interesting that the text was sent, and also that the man who received it felt the need to share it with a journalist.
It’s also interesting that Mr Howlin has argued, on a number of occasions recently, that the health budget has not actually been cut over the past three years (despite, you could say, his best efforts). However, Mr Varadkar prefers to describe that same budget as “held flat”.
But the health minister, while resisting the urge to come out all guns blazing, is still making it clear that he needs a “realistic and adequate budget” for 2015 to maintain services at existing levels and, also, to make improvements.
I rather like his tactic of checking back to see what budget increases Brendan Howlin and Michael Noonan got during the years in which they both served as health minister.
In today’s terms, says Varadkar, who’d obviously done some rough sums on the back of an envelope, the budget would add up to about €650m a year. It’s crucial that these three men come to agreement on that budget. There’s been enough messing with it.
So, Leo Varadkar has us daring to dream that our health service might be at least improved, as well as the morale of the people working in it. He’s playing a good game so far, but will need the absolute support of his colleagues if he is to succeed.
Varadkar has us daring to dream our health service might be improved, as well as the morale of its staff
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