Labour launch damning attack

A heated Dáil debate between Mary Harney and Liz McManus errupted as news broke that the health services' pay-roll system may have to be scrapped

The Labour Party has launched a savage attack on the Tánaiste and Minister for Health, Mary Harney, charging that her record in health is one of missed opportunities and broken promises.

This controversy is erupting just as the Government comes under intense criticism because of the failure of the new computerised pay-roll and staff management system (PPAR) that, despite costing over €150 million, is likely to be scrapped when Health Services Executive (HSE) chief executive, Brendan Drumm, completes a review of its functioning.

Reports that Department of Finance officials raised concerns about the cost and management of the PPAR system last June will add to the pressure.

Nor will the Government be helped by an apparently contradictory line on this issue in the Dáil by the Taoiseach and Tánaiste. Bertie Ahern rejected the criticisms made by Fine Gael leader, Enda Kenny, arguing that it was wrong to compare an initial pay-roll scheme suggestion that would have cost an estimated nine million euro with a different more comprehensive scheme that has so far cost over €150 million.

But Mary Harney's admission that the whole scheme may have to be scrapped, the indications that Government knew of concerns about the scheme four months ago, will help the Opposition charge that this is a rudderless Government that has lost its way.
It appears that Harney decided not to defend the indefensible, but this left the Taoiseach exposed, defending his coalition partner more strongly than she defended herself.

Labour's criticisms, though, are more substantial in their impact on the ordinary citizen, and may pose a real political problem for the Government. In an eight-point critique, Labour health spokesperson Liz McManus argues that the Minister for Health has failed in relation to the crisis in A&E, and that one year on, despite her promises that improvements would be seen "within months" the situation, according to Labour, is as bad as ever, and that HSE chief executive Brendan Drumm has admitted it will take at least two years from now "for improvements to be seen".

In primary care, McManus charges that the Government's 2002 strategy has been stalled because there is no money to fund it, and that this in turn is placing an overwhelming burden on the A&E services.

She asks where are the 30,000 full medical cards that were promised and argues that doctor only cards are no substitute. She specifically criticises the "lack of accountability" of the HSE, with no opportunity to raise questions in the Dáil concerning its functioning; charges that inadequate hygiene facilities in our hospitals are made worse by overcrowding leading to the spread of MRSA, and dismisses the effectiveness of the National Treatment Purchase Fund. Liz McManus says: "five thousand people are awaiting treatment at seven hospitals and of these, 1,000 patients for more than 12 months". She goes on to say that 36 per cent of patients dealt with under the scheme were actually referred for private treatment in the same hospitals for which they were waiting for public treatment, "meaning that consultants have been paid twice for treating the same patient".

Labour's strongest criticism is that Harney is effectively engaged in a privatisation scheme based on the US model, and that her plan to move private beds in public hospitals into new private hospitals "promises investors a return of $62,760 for every $75,000", with up to 42 per cent of the cost of these facilities being met from the public purse.

And Labour concludes its attack by asking where is the legislation to establish an independent nursing home inspectorate or for the repayment of illegal nursing home charges.

The Tánaiste, however, has robustly defended her record. She claims that she implemented the largest structural reform in the health service on time last January with the establishment of the HSE, which will allow a streamlining of health administration that Labour opposed.

She specifically answers the charge of non-accountability by claiming that she made the HSE chief executive an "accounting officer", and attacks Labour for wanting, she says, the accountability "split between the Department and the HSE". However, McManus says that such a "split" would have allowed questions to be raised in the Dáil; now they cannot.
In relation to medical cards, Mary Harney boasts that 200,000 people are now to benefit from the doctor only cards, implementation of which, she says, was held up by the Irish Medical Organisation and not by her. She says that Labour may call this a yellow pack service, but charges that Labour want to give a similar free GP visit scheme to all, including the super-rich, and questions the integrity of the attack being made on her.

In relation to A&E Harney says that her plan is being implemented and will show results, but doesn't contradict HSE chief executive Brendan Drumm's claim that it will take two years to achieve this. However, she says that this winter, for the first time, there will be a new GP out-of-hours service in North Dublin, which will be extended to other areas on a phased basis.

Naturally, the Tánaiste is very defensive of the National Treatment Purchase Fund (NTPF) which was a specific initiative of the PDs. She argues that 35,000 patients have benefited from this scheme and says that for all its criticism Labour will not commit itself to abolish the scheme. They say, she says, that they will "reform" it, but don't specify how.

In this regard, Harney is very anxious to refute charges that she is privatising the health service. Her plan to move private beds in public hospitals to private hospitals is designed, she says to free up public beds, and charges that Labour have not shown how they could be provided more cheaply.

And she ends her retort by claiming that Liz McManus has published no proposals or policies for how to tackle the problems of the health service. It's easy to criticise issues, she says, but harder to find solutions.

This debate obviously goes to the heart of the issues in health, but will be given an added edge by the computer system controversy, and more can be expected to be heard on both issues as health plays a major part in the pre-election debate.

Eoin Ó Murchú is the Eagraí Polaitíochta of RTÉ Raidió na Gaeltachta. He is writing here in a personal capacity.