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New minister must cut coat according to cloth

18 May 2016

Dara Gantly examines the surprise elevation of Wicklow and East Carlow TD Simon Harris to the post of Minister for Health in the 32nd Dáil.

Surprise’ was the word on most people’s lips. Indeed, Simon Harris himself expressed his “surprise and shock” at his appointment as Minister for Health, when the Taoiseach called him in last week and asked him was he “up for a challenge”.

“It wasn’t a role I had expected when I woke up and ate my Corn Flakes that morning,” Harris told the presenter of East Coast FM’s Wicklow This Week programme the day after his appointment.

When Dr Leo Varadkar came out in a radio interview with Miriam O’Callaghan in January 2015, many were shocked to find out his secret. He was only 36! Yet the new Minister for Health is just 29.

1986 was the year of Chernobyl, the Divorce Referendum, and Hurricane Charley. So no bad omens there. That year also saw ‘panda diplomacy’ take centre stage with the arrival of Ming Ming and Ping Ping at Dublin Zoo. And when the youngest member of the 31st Dáil was born, in October 1986, ‘True Blue’ by Madonna was topping the charts. But that’s enough Reeling in the Years.

With the appointment of Simon Harris as Minister for Health, the trend of having a doctor take the pulse of the health service is at an end. After the on-call shifts of Drs James Reilly and Varadkar saw much promise but less delivered, we are now handed over to a career politician with a degree in journalism. So a generalist, not a specialist for Health — but someone who will need all his communication skills to survive this most challenging portfolio (the dreaded ‘hospital pass’, as described by new Minister for Transport Shane Ross last Sunday). At least we can expect headlines from Hawkins House to be that bit better now a ‘journalist’ is in charge.

So what kind of headlines wlil emerge? Already Minister Harris has indicated his desire for a 10-year plan for Health that would be signed up to from all sides of the Oireachtas. He believes such a plan needs to be longer than the life of any government, and he reportedly hopes to establish an all-party committee to look at problems and funding for health into the future.

A motion calling for such a move has been drawn up by the Social Democrats, and was reportedly discussed by Róisín Shortall and Minister Harris on May 7. It also sounds a lot like the Tallaght Strategy-style consensus from all political parties to deliver sustainable, equitable health reform as espoused by the NAGP.

“Such a negotiated consensus by all the parties for a 10-year plan would finally put the patient first. It would create direction and stability similar to the famous Tallaght Strategy of 1987 when our body politic successfully put the country first ahead of political gain during a period of economic and social upheaval,” stated the Association — not the Minister — back in March. Will he be the ‘listening Minister’?

Another Harris headline during his first weekend as Minister involved the ongoing dispute over the relocation of the National Maternity Hospital to the St Vincent’s Hospital campus. In an interview with East Coast FM, he advised those involved in the dispute to “put your egos to one side” and “sort this out”, adding that he would not allow the delivery of a new maternity hospital to be jeopardised over rows about “governance or fiefdoms”.

Of course, there is history here between Harris and both St Vincent’s and Holles Street. During his time on the Public Accounts Committee (PAC), and the debates over the remuneration of CEOs of section 38 and section 39 agencies — dominated, of course, by the Central Remedial Clinic and Rehab controversies — Harris warned against ending up with a situation where “we exhaust one organisation while letting others off the hook”.

On St Vincent’s, in particular, he has previously queried the interpretation of the consultants’ contract at the hospital, “which seems to be unique, if not bizarre”, and the situation that allowed “public buildings mortgaged for the development of private entities” (PAC, July 3, 2014). The NMH was also name-checked during that meeting over its “potential linkages with private business” and its “salary levels”.

And when speaking on the HSE (Financial Matters) Bill 2013 the previous February (27 February 2014), Harris again raised issues surrounding St Vincent’s, referencing ‘Lanigan’s Ball’ when describing the previous set-up, whereby one chief executive was in place for the public and the private hospitals.

In that debate, he described the removal of political responsibility for the health service as one of the biggest mistakes in recent years. “I know from watching Oireachtas committee proceedings before I was elected to this House that Ministers used to shrug their shoulders and say ‘nothing to do with me, not my fault, not my responsibility’. We do not want that sort of health service.”

Looking through the archives, in a much earlier debate on the health service budget (July 11, 2012), Harris acknowledged that it was clear following the years of the Celtic tiger that money alone would not fix the health service. “We have seen money being thrown at it, health budgets being hyped up every time there was an election and money thrown around with scant regard for what it would deliver. What will fix the Irish health service is reform and management. That is what the Minister, Deputy [James] Reilly is about, and it is what Fine Gael and our colleagues in the Labour Party said in the general election campaign [of 2011]. That is our commitment in the programme for Government.”

At time of going to press (May 9), the new official programme for government had yet to be published. But from documents leaked over the previous five days, from the agreement reached by Fine Gael and a number of Independents or the ‘confidence and supply’ arrangement for a Fine Gael-led Government signed up to by Fianna Fáil, we know that most of the main policies for Health were already agreed before the new Minister was even named. His role will be as ‘facilitator’, as he himself has declared. We wish him well.

And what of his Health credentials? He cut his political teeth campaigning for services for autism, was Chairperson of the HSE Regional Health Forum, and the cross-party convenor on mental health, introducing the Mental Health (Anti-Discrimination) Bill 2013 in June 2013. And while on the PAC, he did try to examine how the HSE budget works, “in so far as possible”.

According to, he has spoken in 77 committee discussions and Dáil debates in the past year — well above average.

Minister Harris has promised to “roll up my sleeves and listen to people” and be that facilitator so badly needed in Health. And while he was initially surprised, he said the more he thought about it, the more excited he was about the prospect. For him, Hawkins House was not ‘Angola’ – rather “the greatest challenge of my life”, he noted last weekend. Perhaps we should ask him again about this after the seventh landmine explodes.

“I expect to be held to account by the Dáil. I expect to be questioned; I expect to be put under pressure. But I also want to approach this not in a Punch and Judy way. We need political consensus around health. We need all of our politicians to come together… We have got to come up with a long-term plan.”

Whether his ministerial coat will be Harris Tweed or sackcloth, the new Minister for Health will have to plan his aims and activities in line with his resources. And that has always been the trickiest thing in the world of Health. Perhaps a 10-year strategy will work. Certainly, the odds of escaping unscathed look a whole lot healthier.

Dara Gantly

Click here to view the full article which appeared in Irish Medical Times: Opinion