Closer to Boston than Berlin
The last two weeks have seen a flurry of government members fleeing the political field. Whether one is cynical and attributes this with reference to the old adage regarding the reluctance of rodents to remain aboard the sinking political vessel of the state or fear of a vengeful electorate, the exodus is striking. Fortunately, those decamping have had their loss of employment and return to the 'real world' softened by liberal financial parachutes. And, who knows, Ryanair and their fellow travellers, may have a few spare directorships available for 'worthy' political has-beens.
In their wake, they have bequeathed a socio-economic disaster. The Irish people have been saddled with enormous financial debts not of their making. Thanks to a craven government that has committed every citizen in this country to repaying tens of billions of euros of privately contracted debt – the consequence of a frenzy of unregulated speculation on the part of bankers, developers and their ilk – we are now being forced to endure a highly inequitable, punitive and recovery inhibiting austerity programme. Like the joke in the late 1980s, the most impressive growth sector is once against immigration, with this year's forecast of 50,000 far exceeding the peak of 44,000 in 1989.
One of our 'dear departing' is Mary Harney, the recently resigned Minister for Health. Recently better known for her absences in times of crisis than any positive actions to improve our public health service, Harney's reign has been a particularly negative one.
During her tenure as Minister for Health, Harney has been notable for the realisation in practice of her rigid and inflexible adherence to and conviction in the merits of the free market. Of course, Harney gave us free and frank warning of her neo-liberal predilections in her infamous speech to the American Bar Association in 2000 when she candidly declared that despite our closer physical proximity to Berlin, Ireland was ideologically in the Boston camp with respect to its economic policies.
As chief mandarin of the Irish public health sector, Harney has been at all times animated by an ideology of 'private health good, public health bad', irrespective of the consequences to the health prospects of the Irish public.
In 2008, the public health sector, the target of fierce attacks regarding its spending, effectively subsidised private insurance companies to the tune of €167 million. This largesse was made possible by the abysmal failure of the health service to charge for 180,000 private patients who had been accommodated in public wards that year. As the Comptroller and Auditor General, John Buckley, pointed out at the time:
"The low rate of income recovery from patients who were treated privately in the hospitals reviewed would suggest that the State is facilitating private medicine without getting the related income for the service it provides."
Even though it is one of the largest property owners in Carlow town, the HSE spent €365,000 annually leasing a property at Shamrock Plaza in order to facilitate the provision of GP and other health services. The justification offered for this folly was that there were legal reasons why these services had to be provided on private premises, as the governing scheme stipulates that the public-private provision of health services is not permissible on publicly owned land. Meanwhile, the HSE admitted that some of their premises in Carlow town might have to be sold off to cover the leasing of the property at Shamrock Plaza.
While incidents such as these might appear indicative of a heightened state of insanity to most of us, in the rarefied, ideological atmosphere of the planet Harney orbits, it undoubtedly makes good sense. And this is the nub of the problem.
The failure of the public health service, whether in terms of subsidising the private health sector or delivering substandard care and treatment, have always appeared of relatively scant concern to Harney. Shielded behind a battalion of public relations officials and having opted out of subjecting herself to any forthcoming public accountability at the ballot box, Harney has been able to proceed relatively untroubled in her objective to privatise as much of Ireland as possible.
As Sara Burke, author of Irish Apartheid - Healthcare Inequality in Ireland has cogently argued:
"At its most benign, this increased, unplanned, unregulated privatisation of healthcare can be considered hugely irresponsible of our political leaders. At its most insidious, it could be considered sabotage of the very public health system they are meant to lead."
Professor Sean Tierney, the President of the Irish Medical Organisation, commenting to the Irish Medical Times on Harney's departure:
"She expanded the private sector significantly, while restraining expansion in the public sector in the hospital sector. This has led to a greater proportion of beds in private-for-profit hands, from which the HSE already has to buy space."
Professor Tierney went on to explain that not only did this prove extremely costly to the Irish state in terms of tax breaks but it left many vulnerable social groups such as the disabled, elderly, low-income earners and those with chronic disease in a very precarious position, given the priorities of private health care.
Undeterred, or perhaps more accurately 'boosted' by the purported needs for austerity dictated cutbacks, Harney, when not lolling by the pool in five star hotels around the world, merrily continued on her crusade to dismantle the public health service limb from limb.
Meanwhile the public health sector continues to fall further and further into disarray. For the seriously ill, those left to languish for days on trolleys in the corridors of overcrowded, under-resourced hospitals nationwide, and the demoralised, over-worked and media-mocked public sector staff, the argument that we have no choice but to continue to dismember public services to pay back the recklessly contracted debt of private individuals must seem like a sick joke.
However, while many complain that Harney has failed if not actually actively subverted the Irish public health service, in her own eyes, she would probably regard her reign as having been in many ways a highly successful one. It is just that Harney never saw any reason why she should subject herself to the (vulgar) judgement criteria favoured by the majority of the Irish population.
[Image via Raymond Crowley on Flickr]