Roisin Shortall walks tall

It’s a day on from the bombshell resignation of Roisin Shortall from government.  I was shocked by the move but to be fair, knowing Roisin as I do, She is an honourable woman. What you see with her is what you get. She has always been someone of values who believes in principle. today I was reminded of how over 10 years ago as Education spokesperson she raised the teachers dispute despite it being very unpopular.  About 20 years ago she was one of a number of Labour TD’s to resign the whip in protest at the Cahill Plan for Aer Lingus.

 The debacle will stand out for the remainder of the time that this government is in power as a watermark. But it shouldn’t. The loss of Willie Penrose shouldn’t have happened either.  When Willie resigned it was put to Labour that a local decision cannot be made as the wider interest demanded a strategic organisation of the defence forces.  So Mullingar lost its barracks while Athlone retained its military presence.  Here we have the direct opposite, local decisions are now being made when it suits Fine Gael. Strategic organisational decisions to plan the delivery of a service can now be made based on local criteria. The logic for the decision that led to Willie Penrose’s resignation is now binned.  If anyone should reflect on the last 24 hours and ask what if, it’s Willie.

So let’s park the personality issue because I have no insight into how relations work within a department and instead let’s look at the policy and in particular the criteria around the decision.   If you look at the list of primary care centres Ballymote in South Sligo is 25km from the Ballaghderreen centre that was added by Dr Reilly. Balbriggan also added by Dr Reilly is 14 km from Laytown which in turn is 11 km from the Drogheda primary care centres.  Minister Reilly points to population in the case of Swords demanding a primary care centre so let’s grant him that. Nearly 50,000 do have health need.  So are there 50,000 people living in both North Roscommon and South Sligo to justify each getting a primary care centre? Do these bordering areas have such high levels of deprivation? Or is there a big enough population between Drogheda, Laytown and Balbriggan to justify 3 of the 35 centres to be built nationally? 4 if you add Swords a motorway junction or 2 south of Balbriggan?

A lot of Labour voters and members have contacted me in the last 24 hours to make it clear that they resent the behaviour of Minister Reilly towards Roisin Shortall. That makes this matter different to the resignation of the whip of other Labour TD’s.  This will have implications for day to day government into the future and make framing a budget harder.  I’m not saying there won’t be a budget, the reality is that there will be as the need to drag the country out of the FF & green slump is all consuming and essential.

However it will make all the work like the children’s referendum, the public service, local government  re-organisation which is upcoming fast, all harder. This was needless.     

Enough of Harney picking over the nation's carcass!

Few Ministers have presided for as long as Mary Harney in the history of the state. She’s spent 12 years in office continuously and add to that the period that she spent as a successful Junior Minister at Environment where she pioneered smokeless fuel. Her senior at the time was Padraig Flynn and the pair were nickname Smog n’ Smug!
When Harney transferred to Health in 2004 she told us that she’d bring her business like approach to health and shorten waiting lists, improve services and give us a first class health service. After the latest scandal at Tallaght Hospital she’s no nearer her goal than she was over 5 years ago when she took up the job. In 2005 she said she wanted a 7 year stint to complete her job. Her optimism is groundless, she’s brought us no nearer a better health service. It’s about time we as a nation heeded her advice from another issue and shopped around for another Health Minister.

She really has a dreadful record, Missed diagnosis at Port Laoise, Galway, Limerick, Hospital closures in Monaghan, Ennis, Dundalk as well as the infamous reconfiguration of the Mid-West, North East, South, and South East, the Co Location financing of private hospitals, PPARS, Failure to regulate the nursing home sector, A&E charge doubling in the last 5 years and all the time physiotherapy and psychological services for children services are long fingered as Ms Harney hones her taste for foreign travel. Her constant companion in clocking up the air miles is her FAS veteran husband. What happens in Vegas stays in Vegas, particularly if your on a waiting list for surgery on a vegas nerve.

The ire of most people is kept for her creation , HSE. Patients are glad of a service and appreciate the work done on wards, in operating theatres and clinics up and down the country. What they want to see is more. We are told that Ireland is striving towards best international practise and that at the end the HSE will be held up as a model for other small countries, consultant led teams treating patients in modern speciality hospitals. What we’ve mostly got so far is duplication of management and a Minister who fundamentally cannot distinguish between a social economy and a market. Since 2005 civil servants in the Health Department mirror the HSE employees who work in brand new offices on the Millennium Park HSE complex, leased from her good friend by tax payers. Amid the chaos Harney refers question on health the political section of the HSE. When the Head of the HSE Professor Drumm goes to meet TD’s its bedlam as about 100 deputies try to question him about the implications of his decisions in their own area in a limited amount of time.


I’m fed up with those who run our health system stumbling from crisis to crisis. Where will it be next month? Can we afford any longer Harney’s clichés? Fair deal or “If it was just a question of money it’d be solved by now”. The sad reality is that Harney has demoralised the staff and frightened the general public into an expectation of poor standards in our hospitals. The reality is otherwise. Recently one of my children broke their arm. I went to Wexford General Hospital at 5 PM. My son was x-rayed, diagnosed, treated and referred to a fracture clinic within 2 hours. There are good experiences in our health services to be had in spite of the quality of leadership at top.

So what is the way forward? The genie is out of the bottle, accountability is gone, every day Wexford gets closer to a re-configuration that will mean the service delivery in the South East is regionally based rather than local. If there is a change of government in the morning this roll out won’t change because management have been given control of delivery. It’s reconfiguration or nothing!

The forthcoming re-shuffle is fundamentally different to what Ahern did in 2004 when he morphed into a socialist who broke bread with Fr Sean Healey. That transformed FF in the polls and set them up for 2007. The forthcoming reshuffle is predicated against taxpayers being taken to the cleaners to keep bankers, developers and FF in clover. The most potent expression “There’s no NAMA for me” says it all. There’ll be no bailout for FF, Harney and the Greens.
Enough is enough, The health minister should return from New Zeeland to take control of the latest crisis. Then Harney should be shown the door at the reshuffle, accountability has to start.

Mary washs her hands of Pharmacists and medical card holders

For the past week many medical card holders in the state have had significant difficulties collecting prescription medicines because of a dispute between the Department of Health and the pharmacists association (IPU). Effectively the minister has unilaterally cut payments to those chemists who administer drugs to medical card holders. Nobody likes when a unilateral cut in income has been imposed by a minister, as any public servant paying the pensions levy will quickly tell you. Minister Mary Harney has been her own worse enemy on many matters for some time and she has lost the confidence of the people because she has no mandate from the people.
However that does not necessarily mean that the chemists have the full support in the community. For a few weeks I’ve watched from the sideline while their medical card patients have had to endure great hardship to get medication. Essentially the patients have been used in a row about money to see who’ll blink first and come to the table. The facts are that the state has got poor value for money from administering, purchasing and dispensing drugs to medical card holders. It seems that for a long time the gravy train chugged along merrily. At one stage restrictive practises prevented competition between chemists and pharmacies had to be located a minimum distance from one another serving a verifiable need.
The market has changed hugely since towns have expanded and farming has reduced somewhat. The increase in competition from chains like Boots or McCaughley’s, increased rents on Main St and the establishment of a new school of pharmacy increasing the number of entrants to the market have led to extra outlets in the business. To set up a chemists shop needs compliance with the law in terms of premises location as well as the need to provide a qualified pharmacist on site. There are enormous costs but as long as the population climbs there’s something there for everyone. As part of the business mix, toiletries, drugs to medical card holders as well as non holders of cards and veterinary medicines will contribute to the chemists income. A pharmacist is a business person first and foremost.

However it is not sustainable to continue funding the drugs scheme as it is. Other professionals providing services to the state have seen professional fees cut and in some cases payment deliberately retarded. Pharmacist revoked their contracts to provide medical card holders with drugs, as is their right, to protest against how the department had treated them. If teachers had gone on strike when the pension levy was brought in, we’d have been accused of holding the children’s future hostage (as we were once accused by a parent’ rep). Chemists say that their income will be cut by 34%. I accept that they have overheads, staff to pay and so on but any chemists who I’ve passed by in the last few weeks are doing very little business as most of their customers are down in Boots getting their medication. How sustainable is it to tell the bank that is itself crucifying business by refusing to release money that you’re paying staff the same amount to do less work on an ongoing basis? Chemists feel that they have the department by the throat and that to set up an alternative outlet dispensary the HSE must locate enough qualified chemists and suitable premises to comply with the law. A hard job for the department, but not impossible. During the 2001-02 teachers dispute the Department of Education found a way round our threats on substitution and supervision and I would argue that teaching has suffered since. Chemists should learn from the mistakes of others before they irreversibly damage their industry. Once changed it’ll never return to the way it was before.

My sympathies are entirely with the patients on this one. As long as the stand off continues the more likely it is that chemists will lose good customers and that rationalisation of the industry will see the consolidation of chains at the expense of family run pharmacies in Ireland. There are other issues such as the use of generic drugs in place of branded one and the relationship between the industry and the HSE but these won't get discussed during the dispute. It’s time for the pharmacists to re-open, take up their contracts again and offer to negotiate with the minister. Anything else causes hardship to those who need it least.

FF TD’s resignation stunt officially opens the silly season

I don’t think anyone is fooled anymore by the antics of the 2 FF TD’s in Sligo. They’re wasting their breath spoofing the country. The local FF TD’s in Yeat’s own county have weaved their own spell in words, sounding concerned but doing precious little about it. Because of the centralistion of cancer care in Galway they’ve resigned the FF whip. The 2 TD’s studiously avoid the facts that the NW is the last regions to get breast check on their watch almost 10 years after it was rolled out elsewhere in the country. Where was the FF deputies concern then?


One who is known as a former Minster for State at the Department of Health and was recently sacked by the Taoiseach and the other not even a household name in his own household. The boys are obviously fed up with getting it on the neck from the local electorate about how the HSE is downgrading the local hospital and have opted for the politics of gesture not action. Lets get this straight, Deputy Devins, emphasises he’s still very much a member of Fianna Fail, he wants to only make an issue of local cancer care and doesn’t seem too put out by the other government cuts and to be fair to him he can’t as he voted for them all. So Special Needs Assistants, garda cutbacks, the cutbacks in REPS, social welfare cuts and waiting lists at the HSE everywhere else are something he’ll live with. Indeed even more, he’ll re-join FF in the future according to his interview with Philip Boucher Hayes. Are they going to bite the bullet and vote against FF in the Dail? Not now, not ever, unless a motion is put down to provide cancer services in Sligo.

So if both deputies are genuine in all that they hope to achieve and are confident that they have the people of Sligo behind them then should they not resign their seats and force by-elections, seeking a mandate in the area against the proposed cuts in cancer care and then go back to Brian Cowan with their hand strengthened? Anything less to my mind is self serving and cynical, as was the statement by one deputy that it wasn’t about his seat!

So what are the lessons for us in Wexford? Here we also have 2 FF deputies who’ve made known in the privacy of their parliamentary party meetings unfortunately in the absence of our Minister for Health, Mary Harney. So far their efforts have come to nought so I’ll let you conclude how effective any utterance is in FF. So when the special HSE group reconfiguring the south east hospital recommend the downgrading of A&E in Wexford General Hospital, what will Deputy John Browne (another Junior Minister sacked by Cowan) and Seán Connick do?

Both owe Cowen precious little. John Browne’s long cherished desire to serve in cabinet will go unfulfilled, Connick surely knows he’ll be around for an awful lot longer in political terms than Cowen and surely will note what FF TD’s did exactly 30 years ago when they felt that their seats were in danger during the last Jack Lynch government.
30 years ago FF backbenchers stuck it into the leadership, the question is now have they the bottle now to fight for their communities or not? I wonder did WB Yeats have Fianna Fail in mind when he wrote “I balanced all, brought all to mind, The years to come seemed a waste of breath, A waste of breath the years behind, In balance with this life”?

Monageer 2 years on

The first inkling I had that something untoward had happened on the that fateful day 2 years ago was when I took a call in the afternoon on my mobile phone from a journalist in Reuters in London who had once worked locally. He was looking to make contact with a councillor in Enniscorthy and I passed on the mobile number of the town council chairman. You don’t get calls like that often and I knew instantly that something was up. As I was off class for a few minutes I put on the radio and listened to South East Radio. Sadly on the hour the first reports were coming of the discovery of the bodies of the Dunne Family in Monageer.
The sheer horror of what happened in that house will never fully be known. I accept the conclusions from today’s report arising from the evidence collected and it certainly puts in the public domain the facts as can be established from the record. However I feel that the report is somewhat deficient. Its clear that there was total co-operation and in the circumstances conclusins and recommendations are easy to draw.
As a result I am surprised that sections of the report including recommendations will be blacked out. I wonder why sections are blacked out, there was no blacking out of reports into tragedies like the Whiddy or Stardust Disaster, The Kilkenny Incest Report which Catherine McGuinness wrote was published in full when Brendan Howlin was Minister for Health. Now 15 years on from Brendan’s inquiry, recommendations on future practice are blacked out. Social mores have changed in that15 years. The sense of responsibility and community or intervention has lessened as Harney, McCreevy and Ahern presided over an Ireland where the individual was encouraged to seek the solutions for themselves with the state off their backs.

Whatever about possible libel in relation to the immediate events, why would recommendations be blacked out? Is it because there’s no money or no political will to effect change or both? What does this say about our states commitment to mental health? What we need to know is if the same situation was to happen next week what would the state services do? Telling citizens that you’ll reach again for a black marker is no answer.
Spending on the sector has dropped as a proportion of our health spending. My colleague Davy Hynes has pointed out his opposition to the downgrading of the counties psychiatric hospital at Enniscorthy. Pat Coady our Enniscorthy candidate for Wexford County Council has put the case to retain the services at St Senans especially as no improved service is to be provided in Waterford. Its not as if the county hasn’t been down this road before as 3 years ago a local woman took her 2 children into Wexford Town, called to a local hospital seeking a social worker and when advised that there was no such service available at that hospital promptly left and took her family to a nearby beach and drowned herself and her children. Last year on the anniversary of Monageer another family was found dead following a house fire in Clonroche after the husband killed his wife and then himself.

No out of hours social service is provided in Wexford for people on the edge, after these 3 tragic episodes. If that is the best that could be provided after 15 years of wealth , what can we expect from Mary Harney now? Because it is Minister Harney’s ultimate responsibility not Barry Andrews nor John Maloney. If the will isn’t there at the very top to prioritise mental health I fear that tragedies like Monageer could happen again. I hope I’m very wrong.

Spend more on mental health and save lives

Gay Byrne returned to our screens briefly last night with Ryan Tubridy. As he was finishing up Gay mentioned that this year the number of fatalities on the road are 23 below last years figure and 2007 was low by Irish standards. While this is no way compensation to any one who’s lost a loved one on an accident and I’m conscious of another death this week end in the county, it’s evidence that when the state gives the proper resources to a public service, the results follow. To be fair to Martin Cullen, one of his better decisions was finding a job a few years ago for Gaybo as Chairman of the RSA.

Road deaths used to be the major cause of death to under 25’s but not anymore. Moreover, the relative success of this campaign only highlights the state’s neglect in tackling what is now the main cause of death in this age group, namely self harm. Almost 30 years ago when I was in college a close friend who studied it told me the reality of the Irish figures as could be established then and I was shocked. Today it is unusual for a Coroner’s court in this country to hold a session without a case where a person has chosen to prematurely end their life. It’s usually described in local papers as “tragic” “unexpected” or “shocking”. These words are sufficient in a locality. There is no need for anymore. Few can understand the bleak pit of life that those contemplating such a course find themselves in.

The Samaritans is an organistion that was set up in 1953 by a young vicar in London who was concerned that those people with emotional distress who could be considering ending their own lives had no one to talk to. Now there are 202 branches throughout the UK & Ireland. Typically their experience is challenging our concept of those who contemplate ending their lives. People coping with job loss, bereavement, financial trouble, work stress, depression, alcohol or changed circumstances comprise most of their clients. The word term “death by suicide” has replaced “committed suicide”.

The National Office of Suicide Prevention is the states response to the issue. NOSP (2001) released data that shows 5 times more males die by suicide than females, 405 of all suicides occur in males under 30%. The time span between April and August usually brings the highest number of deaths. www.nosp.ie

Behind the statistics lies the reality of RNLI volunteers who search and retrieve remains in some cases after weeks, the garda who has to notify next of kin, the paramedics, fire fighters, and civil defence. My Labour colleague Cllr Bobby Ireton in Courtown Harbour is regularly called out to help end the agony of the wait for grieving relatives. In some diocese designated priests have been assigned the job of administering where remains were discovered after a death by suicide. In all cases there’s relatives, parents, siblings, loved ones and friends, all asking why and could they have done something?

Despite there being a strategy in place I wonder how well funded it is? I wonder how well it can cope with the present demand. Given what’s happening in the economy and the relative ignorance of the subject and I’m thinking of Bertie Ahern’s advice to economists who warned him of the consequence of his policies in 2007 to commit suicide and Jim McDaid’s 2002 use of the term “selfish bastards”, how well is it prepared to cope with what may possibly see a further increase in suicide levels into the future? I note that the budget for mental health is reduced further into 2009.

That means a greater reliance on voluntary services like the “Samaritans”. The increase in unemployment, financial pressure on mortgages and emotional turmoil caused by an economic downturn will impact on numbers contemplating suicide and I’m concerned that the state is not prepared for this. It should not be so. If the state can respond to road deaths in a co-ordinated manner why can it not do likewise with suicide? Labour is committed to increasing what we spend on mental health, especially in developing a preventative approach.

You can find out more about the Samaritans at www.samaritans.org. If the issue dealt with in this post affects you please call 1850 609090. The nearest branch is in Waterford and can be contacted at 051-872114.

Prevention always better than a cure

A couple of years ago when I first heard of the anti-cervial cancer jab my immediate response was that with 2 young girls in the family there could be no better life long gift parents could give than the anti-cervical vaccine. The cost of about €350 per child was I thought well worth it as I could (and still can) well afford it. Every year about 80 women die of cervical cancer and while the vaccine is not effective against 100% of the causative agents of the cancer, I believe that any parent would want to protect their child’s life, long after the child has become an adult and indeed well into later life. When I grew up I lived near a polio hospital and played football against the teenage residents. It is quite extraordinary that due to scientific advances and vaccine, polio is now effectively extinct in Europe within the last 35 years. It is natural for a parent to do what they can to protect their child regardless of cost.

That’s why many parents are astounded by the latest cut back announced by Mary Harney, the Independent FF Minister for Health & Children. Taking advantage of the media spotlight on the US presidential election, Minister Harney announced the axing of the programme to immunise 12 year old girls against cervical cancer. Her reason? She can’t spare the €10M. It's not so long go during the Foot and Mouth Crisis of 2001 that when the suggestion of vaccinating livestock against FMD was floated and there was no suggestion of a prohibitive cost.

The matter was raised this week in the Dail and the FF/Green response was that instead there will be a screening programme for cervical cancer. This line was successively pushed by FF, Green and independent TD’s including one who recently resigned from FF. Where have these TD’s been for the last year? Were there not a number of inquiries precisely because cancer screening has failed due to the lack of investment? In one case Mary Harney’s office had been contacted by a specialist in Port Laoise outlining his concern at his equipment. Would it not be more efficient to both screen those who are outside the age cohort that are best suited to the vaccine with up to date equipment and vaccinate all 12 year old girls? Why should we tolerate the inevitability of contracting a condition when it can be prevented.

The view that you take the cheap option wasn’t thankfully that of Barry Desmond when he sanctioned the MMR. We had a case in this country where the blood bank took the cheap option and haemophiliacs contracted AIDS as a result. FF of course have form in this area, calling an early general election 20 years ago rather than give money voted by the Dail to the same haemophiliacs organisation. At the back of it all is the reality that someone like me who can stick their hand in their pocket can protect their daughters while those that cannot will never be sure that their daughter’s can be safe.

When Noel Browne discussed his Mother & Child scheme with the hierarchy they grudgingly accepted that the “necessitous poor” could be protected. The new right in FF & the Greens don’t even concede this. Dr James Deeny, Browne’s Departmental Secretary, wrote about his experience in the Department of Health in “To Cure is to Care”. Fundamental to his approach was a view that no woman should be at the mercy of extreme poverty and lack of care. He concluded that when people talk about closing beds and hospitals what they are really talking about is ending services that sick people need. One wonders how long more Minister Harney has to serve but it’s certain that in years to come we won’t be reflecting on her time as a golden era where services flourished.