It is a myth that health is a graveyard of political careers. In the last two and a half decades, Brendan Howlin, Michael Noonan, Brian Cowen and Michael Martin all went onto greater offices after serving in the Department of Health.
Leo Varadkar may well do the same. Mary Harney retired with her reputation as a doer intact, even if her heavily-privatised vision of the health service has not survived the years of austerity. Only James Reilly has bit the dust.
So those who fear (or anticipate) that Simon Harris will have his political ambitions ended by his tenure in Hawkins House might consider the lessons of recent political history before making judgment.
What is true is that the Department of Health is perhaps the most difficult job in Government. Ministers for Health seem to be permanently apologising. Certainly Harris has been doing a lot of it lately.
On Tuesday he was doing it again, after a devastating RTÉ documentary which showed in detail the hardship suffered by many people who are on waiting lists for treatment in hospital.
In the Dáil, answering questions from all the opposition leaders on the reports, the Taoiseach Enda Kenny adopted the Bertie Ahern tactic of reading out a list of investments in the health service in a subdued monotone before agreeing that it’s all desperate altogether and something will definitely have to be done.
Harris was more blunt.
“I said I was ashamed and I meant it. It’s simply wrong,” he said.
Harris also unveiled an action plan to deal with some of the shortcomings in services, in particular in relation to the waiting list for scoliosis, a condition that causes the curvature of the spine. A new operating theatre is to open in Crumlin Children’s Hospital in June. There will be an audit of waiting lists in the hospitals concerned.
“We are responding to what we saw last night,” he told the Dáil, referring to the RTÉ programme.
“Maybe I say ‘this is unacceptable’ too much,” Harris concluded. “But I say it because I mean it, and we’re going to do something about it.”
‘Not a cynic’
Most people in the system are impressed with Harris, with several senior sources yesterday attesting to his sincerity and intelligence. “He’s not a cynic,” says one senior official.
But Harris’s burst of action on Tuesday is in conflict with the general defence of the Department of Health to every accusation of inadequate service - that its role is setting policy and providing funding (which Harris repeated Tuesday in the Dáil) while the HSE’s role is to manage its budgets and provide services.
If it is not his fault, why is he apologising? Because the political reality is that the Minister for Health will carry the can.
Like any department, the minister’s first job is to secure its funding. But the first rule of health is that budgets will always be inadequate; demand always seems to outstrip supply. Moreover, the public expectation of services always exceeds the services are available. Partly that is because expectations rise as services improve.
Unless the system is profoundly reformed, it is hard to see how that will change in the future. Most of the thinking on the issue suggests that this reform will centre around a move towards much greater availability of primary care. But that process moves slowly, and its improvements will be gradual and slow.
The experience of previous health ministers has been that they have a period when people remark that they are trying to do things, before that gives way to questioning if they have done anything, before wondering if anything will ever change. Harris is in the first phase. It won’t last forever.
