Embattled Reilly deserves praise for some unheralded achievements
It says a lot about this minster’s shockingly poor reputation that any word of approval seems misplaced and unwarranted. During his period in office this Fine Gael minister must have broken records for the amount of controversies in which he has been involved. At times he has appeared to be a magnet for anything going around that could cause trouble for the Government. The latest, and perhaps most damaging of these, the medical card issue, has almost guaranteed his exit from that portfolio in the upcoming reshuffle. It is not just Labour Party politicians calling for his head, but also his own parliamentary party colleagues. First, though, they have to form an orderly queue behind the general public.
What got me going on typing a few words of praise for Dr Reilly was a conversation I had quite recently while attending an event to mark the 10th anniversary of the smoking ban. Dr Reilly was one of the speakers, as was former health minister Micheál Martin. One of the small things that made an impression that day was hearing that the minister displayed no preciousness to organisers at who spoke when, or that a former health minister, Micheál Martin, had equal billing.
As Minister Reilly passed our table afterwards I struck up a conversation with the person sitting beside me about how extraordinarily gaffe prone he had been.
The response I got took me aback. “He has done great things as health minister,” Chris Macey, head of advocacy for the Irish Heart Foundation, told me. I asked him to expand and was told that in his area, of chronic disease and prevention, not least smoking, this minister had shown great courage.
“When we talk to people from heart foundations around Europe they tell us how lucky we are. We are seen as international leaders in the area of tobacco, and that we showed courage, such as being the first in Europe to introduce the proposal for plain packaging on packets of cigarettes. Micheál Martin did it before him with the smoking ban, and now James Reilly is doing it. As a result he will be saving lives long after he is no longer a politician.”
The minister continues to battle “manfully”, says Macey, on the issue of obesity, but has powerful vested interests raging against him. The initiative to introduce calories on restaurant menus was not a huge game changer, he said, but at least it’s a start. “This is not to be in any way political, but if you say anything good about the minister it is never taken up anywhere.”
Macey recalled that a few years ago Ireland had the worst stroke services in Europe, but we are now near the top of the league table with our National Stroke Programme. He referenced a quote from Prof Don Berwick, a former top health official in the Obama administration, who mentioned the Irish success programme in a keynote address in the US.
“Nobody understands what we do better. Hundreds of people will be around to spend Christmas dinner with their families as a result of him,” said Macey, who appears in no way naïve or political, but clearly feels that out of fairness credit is due for the good work that has been done.
Almost since James Reilly was appointed there have been calls for him to be removed. The most recent ones have been prompted by the election results, and the hammering suffered by coalition partners Labour and Fine Gael. There seems to be an almost universal public consensus that he has not performed well. On the back of the chat with Macey I decided to ask some other people who deal with Dr Reilly to get their opinions on him.
One of the most interesting was a Labour source who, rather than being the predictable black and white which people usually are when talking about Reilly, also acknowledged the good he has done in public health and preventative measures.
“He knows that we will never be able to afford the type of intensive medicalised model that is currently in use. He is trying to shift our views of hospitals and doctors and our attachment to there being a pill for every ill.”
However, that source believes it is a mistake to appoint a doctor as minister for health. “It comes down to your training and your environment and how you are indoctrinated. Even if you don’t realise it you have a particular view of the world.
So what sort of health minister do we need? “We need someone who will take on the vested interests, not just the consultants and GPs and so on, but also the drug companies. Is it someone who will tell us how to stay healthy, I don’t think so. We need someone that can step back and say realistically what you can do in a short period of time, someone who takes us steadily towards one system of health care and delivery.”
Another person with a good knowledge of Dr Reilly, a prominent trade unionist, described him as having the best of intentions, but as his own worst enemy. He came into office like a tornado, he said, without any political grassroots behind him and is therefore isolated at that level. But he also believes the minister has been on the “receiving end” when it comes to the allocation of financial and human resources, being “left adrift” in Cabinet.
This does get somewhat to the nub of this matter. James Reilly has become the bête noir of this government and, according to the popular narrative, he has never done a good day’s work in the Department of Health. The current thinking goes that his sacking would result in an immediate improvement of the standing of the Government.
But the trade unionist says this government is just the latest to have the attitude of blaming the minister and deciding that “the health service is beyond redemption and just allows the latest debacle to happen”.
“The word is that you can always squeeze health, that there are always inefficiencies and if we, as unions, speak up about it we are only vested interests. In the UK it doesn’t matter which government is in power they believe in the NHS and are proud of it. You never see that with the Irish system. You can’t put the blame for everything at the door of the minister.”
That point is echoed by the Labour politician. “Health has ruined the brightest and the best. No one would say, for instance, that Mary Harney isn’t a bright woman. Or that Micheal Martin, another former health minister, isn’t a bright man. I don’t think the Taoiseach has been loyal to him for too long. I think he recognises that James Reilly has abilities. Health is the issue rather than his incompetence.”
There is no doubt but that James Reilly does himself no favours in the public relations department and that when it comes to his major project — universal health insurance — nobody really believes he can make it happen.
But this is such a major step that no one person, no matter how talented, gifted politically or media savvy they are, could undertake without support. Just as it takes a village to raise a child it takes the belief and hard work of an entire Cabinet to transform a health system.
When Dr Reilly goes there will only be very few who miss him. But it hasn’t been all his fault.
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