Articles of faith

IRISH citizens generally know as little about the Programme for Government as Catholics do about the Bible.

They are aware it exists but do not concern themselves much with its contents. Government ministers, like ministers of religion, refer reverently to their foundational text. They depend on the fact that, apart from themselves and a few political anoraks, not many have a clue about what is actually in it.

Nonetheless, by repeated reference, in authoritative tones, to the sacredness of the document, the citizenry are trained to know that it is akin to those books carried aloft in procession. The contents might be made up, but this is not a time to display our ignorance. No, it is important in an age of disbelief that we should all believe in something. Best then to put it in a corner, put a candle in front of it and if any talk at all is needed, then let it be hushed and suitable.

It was shocking, therefore, to hear Roísín Shortall tell Marian Finucane on Saturday morning that Health Minister James Reilly was frustrating implementation of the Programme for Government. That is akin to accusing a cleric of not believing in God. It is a far more serious charge than the betrayal of colleagues.

Treachery, after all, is simply self-interest by other means.

Like the Bible, the Programme for Government is an amalgam of many books written at different times, by different people. These are seldom the attributed authors, something the scrupulous should not confuse with plagiarism. It is invariably full of internal inconsistencies and, of course, nobody can agree about what it actually means. In so far as it has any definitive authority, that depends much more on who is in power after the events it foretells than the prophesies in the wilderness of those who wrote it originally.

Our current Programme for Government, the agreed policy commitments of Fine Gael and Labour, include the following prophesies:

Primary Care:

* Universal Primary Care will remove fees for GP care and will be introduced within this Government’s term of office;

* Access to primary care without fees will be extended in the first year to claimants of free drugs under the long-term illness scheme at a cost of €17m;

* A new GP contract will provide incentives to GPs to care more intensively for patients with chronic illnesses. This will significantly reduce pressures and demands on the hospital system.

Universal Hospital Care:

* A system of Universal Health Insurance will be introduced by 2016, with the legislative and organisational groundwork for the system complete within this Government’s term of office;

* UHI will provide guaranteed access to care for all in public and private hospitals on the same basis as the privately-insured have now;

* Insurance with a public or private insurer will be compulsory with insurance payments related to ability to pay. The State will pay insurance premia for people on low incomes and subsidise premia for people on middle incomes;

* Everyone will have a choice between competing insurers;

* A White Paper on financing the UHI will be published early in the Government’s first term and will review cost-effective pricing and funding mechanisms for care and care to be covered under UHI.

Like the Dead Sea Scrolls, these documentary fragments of a lost civilisation tell us a lot about the people who wrote them. They were a messianic warrior cult who had an extraordinary sense of their own righteousness. Even though it is now only 18 months ago, it is hard to believe that we once talked of little else except Enda Kenny’s Five Point Plan and Dr Reilly’s Dutch Model.

The Five Point Plan was based on the belief, as are most prophetic teachings, that we live in a corrupt and idolatrous land, and especially are slaves to the false god of broken politics. James, one of Enda’s chosen, and definitely not one of the nine who went to the Green Isle Hotel to eat their breakfast and betray him, was appointed to heal the sick. You would be healed, he promised, by embracing the Dutch Model. The Dutch Model was convincing mainly because nobody knew what it was, which was precisely why everybody felt entitled to sincerely accept it.

BUT those were apocalyptic days. The end of time, or at least the good times, was nigh. People were desperate to believe in anything. And so they renounced broken politics and they swore they believed in the Dutch Model, in James and, of course, in Enda above all. Our current problems began not because of what was believed, but because we did not believe enough and Enda could not govern alone.

An obscure but persistent cult called Labour had to be called into government and its perverse doctrines accommodated. The pristine orthodoxy of the Dutch Model was contaminated by heresies such as Universal Free GP Care. But much worse than that, in a fit of obdurate pride, a promise was made to implement free GP care in the first term of office.

And here is the insolvable conundrum for our prophets and programme writers. In their false pride and unspeakable stupidity, they promised redemption not in God’s own time but in their own.

The fact that Universal Free GP Care and Universal Health Insurance are paradoxical promises is neither here nor there. We have been living on paradoxical promises forever. What will flummox James is that the only promises worth believing in or at least that can be safely delivered on come at the end of time.

This morning Roísín, now crying in the wilderness, will be officially be replaced by Alex White as Minister for Primary Care. He is not a prophet but a lawyer, a Pharisee trained in parsing the texts written by the prophets. Transforming Universal Free GP Care now into Universal Health Insurance later has, of course, all been done before. It is called transubstantiation. Broken politics, like broken promises, can be fixed. It just takes forever.

* Gerard Howlin is a public affairs consultant, and was a government adviser from 1997 to 2007.

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