Public interest sacrificed to cute hoorism

For far too long in Ireland, it seemed to take a dreadful disaster before a problem was treated seriously. Things have changed, however. Now, even after the worst disasters imaginable, we still don't take things seriously. That, at least, is the case with the public organisation responsible for the most appalling of all our recent scandals, the Irish Blood Transfusion Service.

Hard as it is to believe after seven years of awful revelations, the IBTS is still in crisis. The resignation last Friday of its chairwoman, Dr Patricia Barker, amid indications of a poisonous atmosphere on the board is the worst possible indictment of the state of public governance in Ireland. That the Minister who is ultimately to blame, Micheal Martin, is widely regarded as the most able member of the Cabinet makes the whole thing even worse.

The sheer scale of maladministration at what was then called the BTSB would be unbelievable were it not that it can be measured in brutal facts. About 1,500 mothers infected with an incurable illness, hepatitis C. Two hundred and sixty people with haemophilia infected with HIV, and over a third of them dead. Measureless quantities of grief, pain, despair and humiliation for the victims and their loved ones. A cost to the public purse of at least half a billion pounds. Compared to this, all the direct political corruption that rightly disgusts us is rather petty.

The least important of the costs, though one that ought to weigh heavily on the political system, is the irreparable damage to political reputations. Whatever chance of rehabilitation Charles Haughey might have had vanishes at the memory of his contemptuous treatment of the people with haemophilia. Brendan Howlin's reputation as Labour's rising star was severely tarnished by his inadequate response as minister for health to the emerging hepatitis C scandal. The ghost of Brigid McCole will forever haunt Michael Noonan.

One of the key problems that made the disasters possible was the utter inadequacy of the board of the BTSB. The body that ought to have been the main protection for the public completely failed to discover what was going on, never mind discuss it. It got bogged down in details, developed no coherent strategy and never really acted as an independent monitor of what the medical and other staff were doing.

These failures were essentially the fault of successive governments. No one expects a minister for health to know the results of a blood test or the significance of specific technical procedures. What we can and must expect is that the minister appoints a board of independent-minded people willing and able to implement a clear and coherent strategy. The cost of not doing this in the past is appallingly clear. That Micheal Martin has allowed this basic failure to recur is quite scandalous.

After the scandals began to emerge in 1994, the State had no more important task than the creation once and for all of a worldclass blood transfusion service. A new board was brought in. International experts were asked for advice. The Bain Report recommended many structural changes.

One of them was that the testing of blood be centralised in a new headquarters with state-of-the-art facilities in Dublin rather than being split between centres in Dublin and Cork. This was, and is, bitterly opposed by the medical establishment in Cork.

For the public, this is a relatively minor issue. There are reasonable arguments on either side of the case. What mattered was that a coherent strategy be agreed and implemented with clinical efficiency. Instead, for largely political reasons, this petty argument has been allowed to fester so badly that it has infected the entire organisation.

One of the key imperatives of reform - a strong, coherent board with a clear mandate from the Minister - has been sabotaged. The public interest has been sacrificed to factionalism, turf wars and political cute hoorism.

Initially, the decision to centralise blood testing in Dublin was backed by clear Government policy. Brian Cowen as minister for health withstood the pressure and went ahead. For all the protests, the matter was effectively closed.

This time last year the new Minister, Micheal Martin, made five appointments to the board of the IBTS (excluding the formal reappointment of his own Department's representative). Four were from his own Southern Health Board backyard and the fifth was the former FF general secretary, Pat Farrell.

It was obvious at the time that the introduction of this large Cork contingent on to the board was a signal of support for the Cork campaigners. This, in itself, would not have been disastrous if the Minister had then gone ahead and told the board to reverse its policy on centralising testing in Dublin. He didn't. He simply turned what had been an external row between the IBTS and the Cork medical establishment into an internal IBTS row.

The outcome is the IBTS has become effectively ungovernable and that its chairwoman has resigned. This has happened almost entirely because Micheal Martin failed to understand that the blood service is far too sensitive to be used as an arena for local political manoeuvres. Unless he acts immediately to disband the board and appoint one with the unity, expertise and independence to provide a trustworthy service, he is not fit to be Minister.

fotoole@irish-times.ie