Longford Leader columnist Mattie Fox: Public entitled to know true cost of running Irish health service

Mattie Fox

Longford Leader columnist, Mattie Fox

Here is a quote from ‘The Irish Times’ of Monday, February 5, 2018: “Mr Harris suggested the only mistake that he and the HSE director general had made in relation to the budget was that they were too transparent.”

The Irish Health Service, the running of same, and the continuing lack of transparency, or indeed truthful reporting is one of the greatest scandals to hit this country in quite awhile.

The Health Service costs a small fortune, so the least the Irish public can expect is honesty from government.

The Health Service is obliged to provide full information as to the shortfall in the previous year, when budgeting for the next.

For example, if an overrun of say €50 million happens in a particular year, this should be reported and clearly in the estimates for the year that follows.

Not to report, means keeping it “off the books” - a favourite administrative construction by the Department of Health.

Why should the Department take it upon itself not to report fully the exact state of the country’s affairs?

The most recent estimates for Health, to be included in the upcoming budget, are misleading.

The minister, and government officials constantly talk about €5 million here, and a “provision” of €10 million there.....a bit like sweets at a children’s party.

The minister must know full well, that the amounts being discussed are hundreds of millions, given the scale of the health spend in any one year.

But no, instead the Minister uses examples that he feels will satisfy the ‘ordinary’ people.

In 2018, for example, we’ve been subjected to an ongoing argument between the Health Service Executive and the Department - although not generally reported - to resolve the wording used in the document brought forth by the HSE, to make its case.

The documentation illustrates that the HSE wanted to emphasise, in the published plan, concerns that it did not have enough money for services in 2018, while the department objected to such “negativity” and instead wanted it to highlight positive issues such as new developments which were to be funded in the year ahead.

“The overall tone of the document is overly negative and needs to be reworked,” was one remark attributed to the department’s secretary-general, Jim Breslin.

Official background papers make clear there were arguments between the HSE and the Department of Health over how much money was needed for 2018, which is to be expected. But the manner in which the HSE was ordered to hide its concerns over funding gaps from the public in the plan it eventually published is more worrying.

Yes, it goes without saying that the Department - who are the ones ultimately in charge of the Health Service - won the argument and got their wording used insofar as they wanted it to be.

The HSE buckled under pressure and resigned themselves to using wording that they don’t actually agree with just to appease the Department.

The argument went on for several months, during which time again and again the Health Service Executive wanted to retain certain phrases and wording, since it was more accurate and lent transparency to the document being prepared.

No, the Department preferred telling ‘untruths’, about the amounts needed for the HSE to try and do its job.

Let’s see what date will a supplementary contribution be allotted to the Health Service in 2018.

Read more from Mattie Fox:

Sense of peace

GAA should stop bleating about payments to managers

Treatment of women in society has been an enormous travesty

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