The state of the health service is evidence of 10 years of Fianna Fáil failure, argues James Reilly
Some commentators, notably former Fianna Fáil election candidate Noel Whelan in this paper on Saturday, argue that we need a Tallaght Strategy for the health service. More than that, if the Opposition would simply stop playing politics with this issue, then the Government could get on with implementing much-needed reforms.
Funny that. After 10 straight years in power for Fianna Fáil, it is the Opposition's fault that the health service is in a mess. But more on that later.
However, the crux of this issue is that we do not believe that the Government is serious about moving in the right direction. That was the criteria used by Alan Dukes in 1987 when he decided to support much-needed policies of fiscal restraint from the Opposition benches, thereby creating the Tallaght Strategy.
These were policies that Fianna Fáil had spent the previous five years opposing while out of government. Even where the current Government is moving in the right direction in principle, say with the centres of excellence for cancer care, they are approaching it in completely the wrong manner.
Stripping away existing services before better alternatives are in place is no way to build up confidence in a new regime.
After 10½ years of "reform", what have we got to show for it? We don't have the 3,000 beds they promised. We certainly don't have an end to waiting lists. We don't have the 200,000 full medical cards promised and the income threshold, at just over half the minimum wage, is scandalously low.
Then, after a decade in Government with no need of Opposition support in order to implement its health policy, Fianna Fáil commentators start to talk about a new Tallaght Strategy. After 10 years in power, Fianna Fáil is either unable, unwilling or unconvinced by its own policies to implement them.
The only significant change it has managed is the creation of the Health Service Executive. Is Fine Gael really supposed to support a massive bureaucracy that has seen the number of Grade 8 middle managers rise from six in 2000 to 714 in 2007? Furthermore Fianna Fáil has shown no interest in achieving bipartisanship on health. Its governments have never sought to include Fine Gael in meaningful development of health policy let alone offer a formal involvement. Instead it has imposed controversial policy changes without consultation or debate and evaded accountability at every turn.
In the name of "reform", they implement controversial policies such as colocation with no electoral mandate. Or, post-election, they announce the centralisation of cancer services into eight locations without consultation, debate or lead-in time. They begin to remove local services before centres of excellence are in place, they display no plan for the transfer of resources from existing services to the new centres and they allow the possibility that capacity at major hospitals will be over-stretched because of the failure to plan ahead.
It is quite clear that Fianna Fáil is not capable of moving in the right direction on health. Their abysmal record of achievement in majority governments means their credibility as a reformer is in tatters. Spending millions without the necessary reforms will not deliver for the patient. In addition, failing to deliver extra capacity in the public health system will continue to expose the patient to long waiting lists, queues at A&E and cancelled operations.
You see, Fine Gael wants an extra 2,300 public beds delivered, not public hospital lands hived off to private developers with the misguided colocation plan. By the same token we want to see 1,500 community care beds added to the system so that those no longer requiring acute care can move to a more appropriate setting. We also want to see free regular health screening so that we start focusing on keeping people healthy and out of hospital. These are the types of reforms that we think represent a move in the right direction.
After 10 years with pitiful results to show for it in the health arena, Fianna Fáil clearly isn't up to the task. Enda Kenny and I are prepared to support the Government when it introduces initiatives that deliver improved patient care in a timely, efficient and safe manner. What we will not support is spin that claims future plans as current achievements or ill-thought-out policies that will not deliver better patient care.
Dr James Reilly is Fine Gael spokesman on health