Why do we put up with this farce? - Another IT fiasco in HSE

AT a valedictory dinner organised by cabinet colleagues for Taoiseach Enda Kenny and Finance Minister Michael Noonan at Farmleigh, last week, Mr Kenny made a farewell speech. 

He closed it with an entirely appropriate and emotional declaration, underpinned by a challenge to his successor: “This is a wonderful country,” he said, and, pointing to the next man to pick up the baton, Leo Varadkar, Mr Kenny told him to “look after it!”

In the way we all have to recognise that two opposite things can be true at once, if we want to stay sane, it is certainly true that this is a wonderful country, but the negative side of that happy assertion is, sadly, valid, too.

For all the wonderful things about our country, even the most fervent cheerleader would have to accept that there are aspects of it, as there are in all societies, that are ugly and unacceptable. They would have to accept that there are too many things, too many examples of stasis and obstruction, that do us, especially our parliament, no credit. They would have to accept that too many special-interest groups are too influential. They would have to accept that too many arrangements that we regard as normal encourage inequity and exploitation. They would have to accept that there are many things we should change. How enthusiastically the obvious, pressing need for change is embraced — or opposed — is one of the metrics that defines a modern, progressive democracy.

We can, like many other societies, test that theory in many ways. Our housing crisis, driven by the worst aspects of a market corrupted by neo-conservative contempt for the idea of society, is one example. That we are trying to resolve that crisis within the framework that created it hardly augurs well and suggests that we have not learned the obvious lessons. It also suggests that the ideology behind that failure is so embedded in our political culture that it cannot be easily purged. An Garda Síochána’s steadfast, and so far successful, defiance of agencies appointed by our parliament to oversee their work is another example. Though this conversation always carries the caveat that the great majority of the force are admirable, decent public servants, that once-reassuring catchall has been hollowed out by half-a-dozen scandals too many. It is not hard to argue that the behaviour of our police, their refusal at every level to be answerable, verges on the anti-democratic. That so many gardaí would bristle at that accusation just shows how much work the force must do to recover its credibility. That suggestion stands, despite the growing impression that the force prefers to live in its parallel universe, rather than enjoy the respect and credibility of the citizens it exists to protect.

This morning, we report on another HSE scandal, one that will give even the most enthusiastic wear-the-green-jersey cheerleader another pause for thought. The ongoing HSE project to introduce a €35m computer system to maternity hospitals is, like so many other public projects, behind schedule and over-budget. Implementation at one centre, Cork University Maternity Hospital, has cost €500,000 more than was anticipated. The Kerry figure has hit €200,000. Bills are awaited for 17 hospitals, so the overrun will reach many millions. Naturally, outside consultants have been employed to break the logjam.

If this was the first IT fiasco presided over by the HSE, it could be described as a learning exercise, but who can forget the PPARS circus, so criticised by the Comptroller and Auditor General? That watchdog spoke of “administrative and financial inefficiencies and a lack of accountability and monitoring, in relation to escalating costs”. The sense of déjà vu provoked by today’s fiasco challenges any idea that we are dealing with a real-world organisation in which accountability has any meaning. The HSE has 100,000 staff, it is the biggest employer in the State, and it spends €15bn a year. It is incredible that an organisation of that scale, of that importance to our society, cannot be self-sufficient in IT implementation.

We have been told, time and time again, that the HSE is top-heavy with managers. Public sector performance reviews suggest that each one is a paragon, an exemplary, dynamic leader, yet we are faced with multimillion failure after failure. Even in a country where we must embrace myriad versions of reality, this stretches patience. This scandal, and all the others, are an affront to the citizens whose income, whose very solvency, depends on continual optimum performance.

When he picks up the baton later this week, Mr Varadkar will face daunting challenges. It is hard to think of a domestic one that might not be resolved more easily if real accountability (failure matched with consequences) became a core, active principle in this “wonderful country”. We have to shake off this death’s hand failure.

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