Pushing to get health the financial life-support it needs
Simon Harris starts laughing —half-genuinely, half-awkwardly — when the subject is raised.
In an interview with RTÉ Radio’s Today with Seán O’Rourke programme last July, the new health minister said until now there had been a lack of “political leadership” in health.
For some, the remark was a thinly veiled barb against his party’s deputy leader James Reilly and his current cabinet colleague Social Protection Minister Leo Varadkar, both of whom are Mr Harris’ direct predecessors.
However , the Fine Gael TD insists this isn’t what he meant.
During the recession years, the Government’s primary focus was naturally on economic survival, meaning health and other key social areas were by necessity relegated to a secondary role.
However, now that a level of stability has descended on the country’s finances, he says that same “political leadership” offered to the nation’s finances needs to be transferred into services that directly affect the public.
It wasn’t Reilly, Varadkar et al’s fault that health took such a beating during the recession, he says, but now that it is over, the reforms they had previously called for need to be taken fully on board.
“What I meant to say, and ok I regret not saying it, was that this [health] has to be a political priority for Government. In the last five years and before that with previous governments, the understandable priority had to be about economic survival.
“People who sat in this office, colleagues and friends of mine, they found themselves in a position of having to retract health spending and really make tough decisions. I now find myself in a position to re-invest, and that comes with a degree of political leadership that until now wasn’t possible,” he says.
The remark could of course be interpreted as an able and quietly ambitious politician side-stepping a damaging row with more senior colleagues who know, in some cases literally, where the health service bodies are buried. And it is no coincidence that Mr Harris’ call to prioritise health comes at a time when next year’s budget is being negotiated.
But the facts — both medical and political — support the claim.
During the recession, the health service saw its budget slashed by just over 23%, 12,000 staff were lost and already inadequate resources were stretched to their absolute limits, and beyond. The need to address the damage caused to social services by financial crisis, not tax cuts and how much money was put back in your pocket, was also central to what people told opinion polls decided their votes.
And now that the crisis is over — at least in theory — Mr Harris says both points should be listened to by those in power.
While wondering where to start in a health service which currently has half a million people on hospital waiting lists and where a third of all emergency departments have no consultant at night is far from easy, addressing chronic hospital waiting times and beefing up GP resources appear top of the minister’s hopes.
The former was highlighted over the summer when Mr Harris announced a five-point plan to provide greater transparency on which patients are waiting longest, while the latter can be addressed through new GP contract talks set to begin in November, which the Fine Gael TD hopes will help end the long-term shortage of GPs in isolated rural communities.
Under plans set to be put to doctors’ unions this autumn, Mr Harris wants to give GPs the option of setting up in rural parts of the country where no doctor is currently based to help plug chronic gaps in the system through a new State-funded GP salary scheme.
Like the €50m already set aside for waiting list improvements, the new move is likely to costs millions of euro to introduce. However, for Mr Harris, it is essential if health and other areas will be prioritised in the current Dáil.
“There are always going to be parts of this country where it may not be viable to establish a GP practice, but where a GP is needed. That is why I’ve said we want the GP contract negotiations to include the option, and I stress the word ‘option’, of a salaried GP. What we are saying is that if the market can’t provide a GP then I feel as minister for health there is a duty on me to put in place a policy that will,” he says.
Talking up new plans is all well and good, but the big question persists: money. With the budget just a fortnight away, Mr Harris’ push to make health a priority will be dependent on what resources are made available, an issue both Mr Reilly and Mr Varadkar have struggled to overcome in the past.
While stressing he does not want to take part in a “divide and conquer” battle with other departments and that there was no “absolutely perfect” health service during the Celtic Tiger boom, the minister stresses there is a need to have “adequate funding of the health service” — provided “results” can be shown.
Mr Harris wants health to become a Government “priority” in the post-recession era. How strongly his call has been heard may be answered in the weeks to come.
