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Here was a familiar Sinn Féin tableau that could have happened any time between late 2019 and late 2023.
Leader Mary Lou McDonald stood at the dais flanked by two key lieutenants: Pearse Doherty and David Cullinane. There was a professional-looking backdrop showcasing the party’s major new health policy: A Prescription for Change.
The semantics were obvious. This was a party working to pivot the imminent general campaign to allow it return to front-foot attacks on the Government over issues such as health, housing and value for money, rather than continuing to be back-footed over the raft of recent scandals that cast the party into a huge crisis this month.
It knew questions on those scandals were inevitable. There was a lot of coverage, of the Stanley case in particular, in the media over the weekend (led by the reporting of Pat Leahy in The Irish Times). The details that emerged over the past few days reflected much better on the party than it did on Stanley, and bolstered its narrative that it responded in an appropriate manner to the allegations.
The approach of McDonald at the conference was to answer (very patiently) every question fully and at length. Her net messages were: Sinn Féin was not responsible for the “bad behaviour” of Brian Stanley. She regretted the statement she issued when Niall Ó Donnghaile resigned, omitting his inappropriate behaviour. The party would find an alternative candidate in Laois, which was a Sinn Féin seat.
Still, it meant a partial eclipse for the policy paper, spearheaded by party health spokesman David Cullinane. The Waterford TD said, with justification, it was probably the most extensive health policy published by a party ever. It ran to 120 pages and covered every facet of healthcare, disability services and mental health.
There are some big promises: an additional 5,000 hospital beds by 2031; four new public elective hospitals; a new maternity hospital; a new ED facility in the midwest; an extra 40,000 healthcare workers; a mental health action plan; a new form of public GP contract (with 250 initial recruits): and a guarantee of a job to Irish health graduates.
To give Cullinane his due, the document is well researched and is the result of thousands of meetings and conversations over the past number of years.
“I don’t believe that we should accept failure as normal in healthcare,” he said. “It is not acceptable to me that patients are on hospital trolleys all year round. I don’t accept that children with disabilities should have to wait for an assessment to access therapies, and a child with scoliosis or spina bifida is waiting years for treatment. I don’t accept that a person waits weeks to see a GP or that medical. Card patients can’t get access to a dentist. All of that is failure, and we can’t accept a normalisation of failure in health.”
They are big-ticket items and, unsurprisingly, there is a big-ticket increase in spending. It would mean a net additional current expenditure of €4.4 billion every year from 2029. That’s taking into account €1 billion of “efficiencies” and savings Sinn Féin believes can be achieved in the Health Service Executive. The capital spending is also twice that of current Government plans, a cool €15 billion between now and 2029. That would be funded from existing capital allocations to health (€9 billion), plus a €2 billion raid on the Apple fund; as well as once-off use of the corporate tax surplus for the remaining €4 billion.
It is as detailed a policy as has been produced and will give the party strong leverage in any election debate on health policy, even though its ambition and high costs will face very close scrutiny.
The party, however, will be happy to ship criticism on a policy matter for a change.
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