Government health policy should be thrown out along with Harney

BY CAOIMHGHÍN Ó CAOLÁIN TD

By the time you read this Mary Harney will have survived the no-confidence vote in the Dáil. But the already shredded credibility of the Fianna Fáil-Green-PD Government on health will have been put through the shredder yet again.
The motion of no-confidence was made necessary by the revelation at the Joint Oireachtas Committee on Health and Children last Thursday that 97 women in the Midlands had to be recalled after their ultrasound scans were reviewed. The plight of these 97 women, who heard the news through the media is appalling. Why did they hear it through the media? Because it was revealed first in a public presentation by a HSE official at that Oireachtas Health Committee.
We then had a situation where both the Health Minister Mary Harney and the Chief Executive of the Health Service Executive Professor Brendan Drumm stated that this public presentation at an Oireachtas Committee was the first they heard about the review of the ultrasound scans.
In countless written replies to Dáil questions the Minister states that the funding, management and delivery of health and personal social services are the responsibility of the HSE. Between them the Minister’s Department and the HSE have failed miserably in terms of the effective and targeted funding, proper management and the patent-centred delivery of cancer services.
In the case of diagnostic services for women in the Midlands the failure has been catastrophic. And the crisis is not confined to the Midlands. Questions have been raised about other hospitals and other professionals. Thousands of women are being put through emotional turmoil as a result. It is not confined to the 3,000 whose mammograms were reviewed in the Midlands. Thankfully the vast majority have been given the all-clear but these women were put through an unnecessary ordeal and others may face the same as the dysfunction in diagnostic cancer services is unravelled.
When the Dáil had a debate on 7 November on the cancer services crisis I highlighted the concerns of the Well Woman organisation over the ongoing outsourcing of smear tests for cervical cancer to the US for analysis, and by the absence of any clear information as to what cytology laboratories will be used to underpin the National Cervical Screening Programme from January 2008.  I did not get adequate answers from the Health Minister. I hope that further grief and tragedy is not being stored up for the future with the approach taken to this vital area of women’s health.
Speaking in that debate Minister Harney stated that patient safety should come first. That is absolutely correct. She said patient safety should come before hospitals, before constituencies, before the professions. That is the priority for all of us. The difference is that Minister Harney has been in the responsible position for a long time now. She cannot shirk her responsibility or that of her Department or the HSE for this situation. The HSE is charged with maintaining standards and managing the health services. This crisis situation in diagnostic cancer services should never have arisen in the first place. A shadow has been cast over diagnostic cancer services for all women in this state.
Let it not be forgotten that the issue here is not confined to the competence of health professionals or the suitability of our cancer care infrastructure and its location. This is also about access to services and how our grossly inequitable two-tier health system affects access. The late Susie Long, as a public patient, was denied speedy access to a diagnostic procedure that, if received in time, could have detected her cancer and saved her life. That courageous woman took the decision to highlight her plight nationally – not to seek personal redress for herself and her family but to expose the apartheid in our health services. This apartheid saw patients with access to private care being diagnosed in time while Susie’s diagnosis was too late. How many more Susie Longs have there been? How many in the area of cancer care alone? How many in other areas of care where there are two waiting lists and two parallel systems, public and private?
Early in her role as Health Minister, Deputy Harney showed her true PD colours. She said in 2004 that she believed in “a minimalist role for the State in all our lives, including health care” and the following year she said the fact that “more and more people are getting private health care is a good thing. It’s a sign of increasing disposable income.”
How many Fianna Fáil TDs remember that their General Election manifesto in 2002 committed them to “the end of the two-tier health system”? The 2001 Health Strategy had committed them to equity by developing policies (i) to reduce the differences in health status currently running across the social spectrum in Ireland and (ii) to ensure access to services based on need. Those commitments today read like a sick joke.
In the 29th Dáil Government health policy was driven by the PD philosophy of Health Minister Mary Harney. Fianna Fáil in government have fully backed and endorsed her privatisation approach. It is now as much their’s as her’s. There have been some whimpers of dissent from the Fianna Fáil benches but for the most part they have followed the Taoiseach in hiding behind the Minister who in turn hides behind the HSE. Now there is nowhere left to hide. All of them – the Taoiseach, the Minister, the HSE management, the sheep on the government back benches have been exposed in their culpability for the shambles of our public health services.
Sinn Féin has no confidence in Minister Harney because we have no confidence in this government’s healthcare policy and in its management of our health services. We could list many reasons for Minister Harney to go and for this Government to go. They include:

• The scandal in cancer care, especially for women.
• The flawed plan for delivery of centres of excellence for cancer care which has been so long delayed and which will leave whole regions without proper services.
• The discrimination against people infected with Hepatitis C and HIV through blood transfusion.
• The downgrading of services at local hospitals and the threats to services at others including Monaghan, Cavan, Dundalk, Navan, Roscommon, Sligo, Letterkenny, Nenagh, Ennis, Tralee.

It is time to challenge Government deputies who talk out of both sides of  their mouths. They can no longer get away with one message for their constituents and another message for the Government they support.
It is also time to challenge the badge ‘independent’ which is worn so proudly by some TDs. If they cannot support a motion of no confidence in the Minister for Health and Children they have lost any shred of credibility in calling themselves ‘independent’.
Minister Harney should go – she should never have been appointed in the first place – but that will not be enough. Government policy must also change fundamentally and there must be real political accountability for health policy and health service management.