APOLOGIES HAVE been offered by the Minister for Health Mary Harney and the chief executive of the Health Service Executive Prof Brendan Drumm to nine women who received the all-clear for cancer at Portlaoise hospital and were later found to have the disease.
Investigators blamed poor quality equipment and inadequate reports for the mistakes made. And a systemic weakness of governance, management and communication was identified within the HSE. But no single individual was named or blamed.
When a succession of Government Ministers refuse to take responsibility for organisational failures caused by their actions, or their inaction, how can we expect public servants to behave differently? And, without accountability, how can services be improved and incompetence rooted out? The reality is that nothing will change without a seismic shift in our political and administrative culture. And there is no sign of that happening.
Political fudge is endemic in the system. Ms Harney delivered her personal "get out of jail" card on this controversy last November when she explained to an Oireachtas committee that while policy was a matter for the Minister and operational issues a matter for the HSE, there were many areas where they could not be separated. Operational issues, she said, had policy implications and vice versa. On that basis, responsibility can always be avoided at the highest level.
But what about the systemic weakness of governance, management and communication identified within the HSE? Can anything be done about that? This bloated organisation, established by the last government, has become a useful diversionary target for Fianna Fáil Ministers and backbenchers. The HSE may be Prof Drumm's responsibility, but it was Fianna Fáil that insisted there should be no redundancies when the old health boards were abolished. And what of the Opposition parties? Those TDs who shout loudest about inadequate medical treatment and poor quality administration are the first to criticise the proposed closure of local facilities and a centralisation of services.
The Irish Association of Social Workers (IASW) has pointed out the dysfunctional gap that exists between official policy and administrative practice. Primary healthcare in the community has been trumpeted as the answer to overcrowded hospitals and struggling A&E services. But, according to the IASW, funding has been so reduced by the HSE in some areas that patients are forced to remain in hospital because basic services cannot be provided in their homes. In addition, real hardship is being caused to older people and their carers. Such an approach worsens hospital waiting lists and represents a gross waste of resources.
Public confidence in the health system is waning. This has been encouraged by the dual nature of the service provided, where those without medical insurance join long queues and receive inadequate care. It reflects broken political promises and a failure to provide high quality services. Most of all, it stems from a failure to put the needs of patients first.