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Ó Caoláin - The buck stops with every Minister for Health since 1976

10 March, 2005


Speaking during statements on the Travers Report in the Dáil this afternoon, Sinn Féin Dáil Leader Caoimhghin Ó Caoláin TD said, "The Minister for Health and Children has tried to shift all the responsibility onto the shoulders of the civil servants. While senior civil servants clearly cannot be exonerated, it is beyond question that the primary responsibility rests with Ministers who are supposed to be accountable to the Dáil and to the people."

Deputy Ó Caoláin went on to say that, „This report has exposed executive failure on a huge scale and over the space of nearly 30 years. The buck stops on the desk of every Minister for Health since 1976 and every Cabinet since then must share collective responsibility."

He concluded by saying, "People should not tolerate any diminution of health and social services as a result of the ineptitude and the neglect of successive Governments. We will strongly oppose any such penalising of people in need. It must not be allowed to happen. The Government must look elsewhere for this revenue, whether by borrowing or otherwise, but do not let it compound this very serious situation by punishing those who depend most on the health and social services." ENDS

Full text of contribution of Caoimhghin O Caoláin to Statements on the Travers Report

"The Travers Report is a massive indictment of successive Governments and successive Minister for Health since 1976. It is also an indictment of the ethos within the senior management of the Department of Health over the same period.

"The present Minister for Health and Children has tried to shift all the responsibility onto the shoulders of the civil servants. While senior civil servants clearly cannot be exonerated, it is beyond question that the primary responsibility rests with Ministers who are supposed to be accountable to the Dáil and to the people. Ministers are elected by the Dáil to exercise executive functions. This report has exposed executive failure on a huge scale and over the space of nearly 30 years. The buck stops on the desk of every Minister for Health since 1976 and every Cabinet since then must share collective responsibility.

"We are expected to believe that the former General Secretary of the Department, Michael Kelly, was a chief culprit in all of this and that, as a result, he has been penalized by being moved out of the Department. But the Government has moved him to another senior and very well-paid position as the full-time chairperson of the Higher Education Authority - despite the fact that an OECD report recommended an extensive public recruitment campaign for this position. If the Government considers this civil servant culpable why did they not take steps to dismiss him as they are empoweres to do? If he was not culpable or negligent why was he moved or required to move at all? Does the Government fear that a dismissal, if it were challenged in open court, might further expose the responsibility of Ministers for this debacle?

"Who in particular does the Government hold responsible? If all senior civil servants in the Department over nearly 30 years were responsible then no-one was responsible. Yet this is going to cost billions. Even in the smallest GAA club in the country, if funds are misappropriated or mismanaged the treasurer has to take responsibility for what happened on his or her watch. The treasurers in this case were successive Ministers for Health. But it is harder to get a camel through the eye of a needle than it is for a member of the political elite in this State to accept responsibility and to abide by the consequences, up to and including resignation or dismissal.

The Travers report concludes:

"Ministers should insist on full and periodic briefings on key issues of policy and operational performance."

"If Ministers did not do this in relation to the illegal charges it is a scandal. If they did so then we are not being told the truth about the knowledge of successive Ministers for Health and Children.

"This report describes the illegal charging of people in care as being the result of 'long-term systematic corporate failure". It beggars belief that this could have continued for almost thirty years. It also beggars belief that successive Ministers for Health and Children failed to take action over the lack of legal basis for the charges.

"The Report could not be clearer when it states that the Department of Health and Children undertook many reviews of the charging practice over the years from 1976 to 2004 and ALL of them concluded that the legal basis for the charges was, at the very least, uncertain and should be rectified by the introduction of amending legislation.

"The Report concludes that a solution to this problem was readily available through the introduction of a simple legislative amendment. Why was this course of action not taken?

"Even more disturbing are the wider implications of this report for the running of the health services in this State over the last three decades. I want to highlight what I consider a very important conclusion of the Report and one that has received little attention so far. This goes to the heart of why all of this was allowed to continue for so long. The report makes findings about why it took from 1976 until 2004 for the Department of Health and Children to request legal advice from the Attorney General. Among the underlying reasons it finds:

'A strong desire to protect what was regarded as an important source of 'own income‚ by the health boards as a means of protecting the provisions of essential health services in a system widely regarded as being under-funded.'

"The import of that statement is very serious. Underfunding of the health services by successive Governments contributed to the belief that the illegal charges as a source of funding for health boards should not be threatened. It was judged better to continue to charge people illegally than to take the necessary decisions to increase revenue for the health system, to reform it and to organise public services on a more equitable and efficient basis.

"What does that tell us about the mindset within the political and civil service management of the health services? It can only be described as ad hocery, a reckless disregard for the future, a vista that saw only as far as the end of a term of office. As a result of that short-sightedness the State's finances will now face a huge challenge to meet the bill for repayment.

"The Minister for Health and Children and the Minister for Finance have both stated that this massive bill will directly effect the overall health budget in terms of a negative impact on the future provision of services. Let us make one thing very clear. People should not tolerate any diminution of health and social services as a result of the ineptitude and the neglect of successive Governments. We will strongly oppose any such penalizing of people in need. It must not be allowed to happen. The Government must look elsewhere for this revenue, whether by borrowing or otherwise, but do not let it compound this very serious situation by punishing those who depend most on the health and social services."ENDS

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