Sign in. It’s quick, free and it’s up to you.
An account is an optional way to support the work we do. Find out more.
LAST UPDATE | 6 Oct 2021
THE MOST SENIOR civil servant in the Department of Health has rejected any suggestion that there is a “vast conspiracy” to block the introduction of universal healthcare in Ireland.
During an Oireachtas committee appearance today, the Health Minister also insisted that no frustrations had been raised with him before the Sláintecare programme was hit with recent resignations.
Robert Watt, the secretary-general of the Department of Health, appeared before the Health Committee alongside Health Minister Stephen Donnelly.
Questions have been asked about the future of the initiative aimed at introducing universal healthcare in Ireland following a number of high-profile resignations.
Gastroenterologist Professor Anthony O’Connor confirmed he had left the Sláintecare Implementation Advisory Council (SIAC) last week, following in the footsteps of chairman Dr Tom Keane and executive director Laura Magahy.
During an at-times testy appearance, both Donnelly and Watt pushed back against the idea that the Government is not committed to Sláintecare.
Responding to a question from Gino Kenny TD, Watt asked for evidence that progress on the major reform is being blocked by “institutional resistance”.
Watt described such suggestions as “nonsense” and “vast conspiracies”.
The recent resignations dominated questions from parliamentarians.
Donnelly told the committee he regrets the resignations but said he was not aware of any concerns among those who quit.
“Neither Tom or Laura raised any frustrations with me,” Donnelly told the committee.
“Neither raised the issues with me or sought a meeting with me.
“I would very much have liked if the issues had been flagged earlier.”
Asked by Fine Gael TD whether department officials might have been aware of the frustrations, Donnelly said: “I can’t speak for what other people may know.”
Watt insisted there had not been policy disagreements between officials and those who resigned.
He said there is “no settled view” in the Department of Health on the particularly controversial issue of regionalisation, which would see the creation of new regional health areas in the health service.
Sinn Fein health spokesman and committee member David Cullinane expressed incredulity at such a claim.
“It’s hard to comprehend there was no sense of disagreement that would have led to their resignations,” he said.
He accused Donnelly and Watt of having a “nothing to see here” attitude.
Watt said he believes Magahy resigned because the Sláintecare office had not been set up properly.
“I think, ultimately, Laura felt that the office wasn’t set up properly and that it wasn’t going to be delivered properly unless we actually embedded the philosophy, the culture and the projects across the department,” he said.
“That’s the key lesson for me, in terms of what happened, that we need to look at our delivery structure and learn from it.”
He said the Department of Health is undergoing a process of restructuring.
Donnelly said in his opening statement to the committee that a new board will be formed that will be co-chaired by Mr Watt and HSE chief Paul Reid.
The motives behind this reform were questioned by several committee members.
Social Democrats co-leader Roisin Shortall said it looks like a “hostile takeover”.
Donnelly told the committee that accountability “will be shared across the department”.
Shortall told the minister: “It sounds like a continuation of this concern about attempts to suffocate Sláintecare.”
She said making the HSE and the department responsible for their own reforms clashes with the “democratic decision” of the Dail.
In a back-and-forth with Green Party TD Neasa Hourigan, Watt also said that he and Reid are “accountable to the minister, the Government and this committee”.
He said there had been “healthy debate” in the department about the timeline of the project and that one of the major barriers, since the start of the Covid-19 pandemic, had been the “bandwidth of the senior team”.
As Ireland emerges from the pandemic, Watt said that is now changing and regionalisation will still be delivered.
Donnelly also said a group will be created to advise on the next steps in the process.
He backed up his official, while acknowledging the worry that a “conflict” exists.
“We are tasking the centre with reducing its authority or executive bandwidth,” the Health Minister said.
“The only people who can lead it are the senior leadership teams in the organisations.”
“There is evidence of that in large-scale change all over the world.”
Acknowledging the resignations have damaged the perception of Sláintecare, Donnelly insisted progress is being made.
He told the committee: “That commitment is absolute and unwavering. Universal healthcare has never been achieved in Ireland and we are still far from it today. Changing that, making universal healthcare a reality, is one of the defining projects of our time.”
He also said tackling long waiting lists is a “number one priority”.
He added: “They were terrible before Covid and have worsened since. People are living in pain. The long waits that many of our citizens face in order to access care are causing immense distress.”
He said a taskforce will now try to address the pressing issue and will be modelled on the vaccine taskforce that planned and delivered the jabs programme.
To embed this post, copy the code below on your site
Putting people from the HSE in charge of something when they can’t even do the job they have now. Only in Ireland.
@Odd Socks: who else would you put in charge of a healthcare project though? If they hired in external consultants there would be complaints about the cost of hiring in external consultants?
@D. Memery: who else? Not Paul Reid for starters.
@Odd Socks: if they could not do the job now one might agree, but actually, by in large, the HSE has kept lots of people alive during the pandemic with their public health advice. Only in Ireland do we knock success and the more success the more knocking. I note you have proposed no one? But anti establishment should stop and we need people,, all people, to support good projects such as this and stop moaning from the sidelines and, I guess, making wild assertions without access to full information or facts. Sounds like a political agenda to me. Are you so tiny minded that you cannot congratulate the appointees and wish them success instead of playing the 19th century gutter game of knocking everyone’s success
@D. Memery: I don’t think there would be any complaints to be honest with you. We have a man who only 11 years ago was cable joiner technician for Eircom in charge of a 20+ BILLION EURO health budget.
Before that, we had a health minister who only has a leaving cert and was a college dropout.
I think we need to seriously look at bringing in external experts before thing get worse.
@D. Memery: its nothing to do with costs. It’s putting someone in charge that is able to manage people and a budget and have accountability and consequences if the fail. So someone from a newsagents might do. Not the people from the HSE that have proven time and time again that they can’t do the job.. And just get moved on to another department to hide their failings.
@Niall Ó Cofaigh: The medical side of the HSE is not the main problem it is the management and civil service part of it that causes all the problems.
Spend some time relying on the HSE and you soon find out how bad it is.
@Niall Ó Cofaigh: Why congratulate a man who can’t, and hasn’t done, the job he is grossly overpaid for since he took over from his predecessor. Kept lots alive..remember the poor elderly. The many who died from other illnesses during and pre covid who never managed to see a consultant. The many who are still waiting. The many cases that have been settled because of negligence 18illion yesterday. Lack of beds, staff, lack of services. No he decides not need or deserve another job he is ill equipped to do.
@Niall Ó Cofaigh:. All the top management in the HSE wanted to do in the pandemic save the HSE by hiding the mismanagement of a budget and staff. They keep say we have to protect the HSE. Nothing to do with saving life’s.. The volunteers in the vaxcine centres the local GPS, the doctors and nurses, shop assistant, did a great job. Not the HSE management. What about the people that couldn’t get appointments for Hart disease. Cancer, mental health. That couldn’t get appointments. And maybe to late for them now. Just so the mismanagement could be covered up…. So no the HSE management didn’t do a great job.. And now their failings have been seen so they are getting moved on to another department. To avoid consequences.
@Odd Socks: this being the same HSE that has delivered the most effective vaccine programme in the world ?
@Odd Socks:
An Army of Lions led by donkeys.
@Niall Ó Cofaigh: you do realise this is the same HSE that sent people back to nursing homes in March 2020 without COVID tests. The HSE as an entity didn’t save those lives during COVID. Doctors and nurses. Why should we congratulate the appointees? I will congratulate then when the achieve something in the role. Sláintecare was supposed to be run outside the HSE because there is so much resistance within the HSE for it. That’s the problem.
@Stephen Kearon: it’s the same HSE that has nearly 1 million people on waiting lists. Just because the people they outsourced the logistics of the vaccine rollout to did a great job, doesn’t mean the HSE is a success.
So the people who are at the top of the failed entity which is the HSE are now going to spearhead the saviour of the Irish healthcare system which is Slaintecare, Is it just me that thinks this project is already doomed?
@Derek Lyster: To HSE or Not HSE. So who here believes Slaintecare as originally presented and laid out as an aspiration/proposal, or at least as we were all led to believe, we were going to have delivered to us in the coming years, is now going to materialise?
This new Slaintecare vision of a free health service for every citizen, was amongst other things, going to be used to encourage our sisters and brothers in the neighbouring state on this island, to join us in peace and prosperity in one new state. Hard to believe there’s not more than one conspiracy at work in trying to wreck what started out as a very genuine and worthwhile project.
I shudder to think of what kind of Mickey Mouse Slaintecare service we’ll now eventually end up with in the end?
It needs people from outside of hse to run this not yes men to government Paul Reid will probably double his salary and it still won’t work
@Michael Dikie Foran: Think you’ll find the government are yes men to Paul Reid. He’s managed to make our healthcare system one of the best financed healthcare systems in the world but not make it any better in terms of service. Government can’t sack him because the of the HSE management system and union.
@Roy Dowling: Can you elaborate on your claim of our healthcare system being one of the “best financed” in the world?
@Ajax Penumbra: https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
16th in the world per capita, far ahead of the likes of the UK, increasing year on year…..
@Roy Dowling: we are well outside the top 5 in Europe. We spend 5% of our health budget on Mental health compared to 12% in the UK and New Zealand.
@Adam J: Too bad you can’t buy equipment on a per-capita sliding scale. A €5m bit of kit is €5m.
@Ajax Penumbra: no denying they throw loads of money at the health system. Problem is that a large portion is squandered or used inefficiently. Money isn’t the problem, incompetence is more often than not.
@Roy Dowling: Dont blame the unions on this. They have fought against the lowering of standards and the privatisation of so much of the ancillary work.
@Roy Dowling: exactly….
@Paul Shepherd: too many Chiefs not enough indians
@OConnelj: So we spend 95% on other things and they only spend 88%?
@Thomas O’ Donnell: correct. No home work for you tonight Thomas.
@Roy Dowling: yes it is best financed but doesn’t work efficiently
@Adam J: Those figures are for Government and Private Health Care combined. If you only consider Government funding the health care service is even more well-financed, around 5th or 6th best funded per capita worldwide.
@Roy Dowling: a polished turd is still a turd
No conflict of interest whatsoever. Another shambolic decision ala Children’s hospital location.
Apparently the plan is to split the HSE into regions… hmmm.. I seem to remember the health board was regions and we were told it would be better to have a single entity…. indeed.. looks like they know what they are doing…..
@John Bathe: The HSE is already regions
@⚡ Seánie ⚡: when first created the HSE was a single non-regionalised entity, it was then regionalised as a political move to try and getcit back towards the model of the regional health boards without actually admitting a single entity model was a bad idea
@⚡ Seánie ⚡: nether regions
It’s difficult to comprehend the thought process that led to these appointments but one thing is now certain, Slaintecare is dead in the water. It’s going to take decades to undo the damage caused by this government.
@Declan Doherty: Slaintecare is a cross party initiative, not government.
@GrumpyAulFella: Slaintecare has cross party support but it is being implemented by the government. The government decided these latest appointments and the government is ultimately responsible for its success or failure. As of now they’re responsible for its failure which isn’t a shock given their consistent failures on pretty much every initiative across the board.
@Declan Doherty: it was a cross party plan drawn up by a committee chaired by Roisin Shortall though. It sounds as though the plan was not viable or there are individuals or groups blocking progress perhaps.
@GrumpyAulFella: yes. Individuals within Government and the HSE
I despair.
@OConnelj: You are not alone.
I thought the original point was to have an independent group from the HSE not of the HSE and the government. This fell nicely into FG hands. Lovely, they will come up with stuff the HSE and the government are comfortable with. Just what the people need.
Queue another pay rise for Watt!
@John Long: the man from DPER who oversaw the NCH money pit farce. “We thought we knew the final cost but that wasn’t the case” and then promoted to Sec Gen of the DoH. Sure it’s only money.
So in other words “No Change” in our health system same old, same old crowd and its quite obvious that government want no Slaintecare!
With four major resignations from Slaintecare, the top man that stands accused of hindering it, has now been put in charge of it by the Dail Mafia. Says it all!
Universal healthcare was the brain fart of former FG health minister James Reilly. Millions spent until Leo as health minister dismiss the idea.
Universal healthcare and Sláintecare are two different approaches. James Reilly commitment was also absolute and unwavering in dealing with waiting lists.
What we need is a dail sub committee. Nothing more or less. Let those we elect honour their election promises. Not unelected health officials with no experience in health. It was HSE management that derailed Sláintecare to protect themselves and vested interests.
Now the same management is going to co-chaired their own hand picked stool pigeons. Away
Sláintecare like Universal healthcare has lost to vested interested and waiting lists will only get longer.
@leartius: Slaintecare i.e. public sector quangos have been so successful at the providing health care that we’re going to give them more money + more control over the system without any real reform – what could go wrong
Why are there so many “I think”s and “maybe”s? Surely these high ranking and very well paid officials were subjected to exit interviews and interrogated to within an inch of their lives as to what they perceived as being the problems that were so immense that these issues forced their resignations. Why are Watt and Donnelly pretending that they don’t know what these issues are? Is it plausible that nobody has ever raised any concerns over these issues before these 3 resigned? Surely that’s not the case. It’s hard to believe a word of this. Putting Reid and Watt in charge sounds like a move to stifle internal HSE unrest and obstruction by hiding it from he public eye or at least filtering it through these 2.
Who is opposing this and why? That is the real question.
@potnoodle: The now top man that stands accused of hindering it, has now been put in charge of it by the Dail Mafia. You couldn’t make it up.
A board of 6 ? with 2 chairmen, interesting governance structure.
Eddie Molloy is another member , who are the other 3?
Ridiculous appointing a HSE official to oversee the set up of slainte care. The govt have no appetite to introduce it as it will affect the private insurance health system. Its just more window dressing over a doomed project.
@Matt: just to add there are plenty of cronies already getting huge amounts of money sitting around, including tds consultants advisors and the likes. While paul reid is occupied with slainte care who is doing his hse work.
@Matt: When in fairness did Paul Reid ever do his H.S.E work!! If he is preoccupied with Slaintecare maybe, if we are lucky, someone with actual ability and experience might take over.
@Matt Yes indeed. Its like the Dublin government appointing the DUP leader to write up a white paper on the replacement of N.I. with a new United Ireland, and with the remaining panel member made up of Orange Order members.
I’m guna go ahead and believe the three people who left.
90k pay rise for watt?
The German system of universal insurance is the best
https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
16th in the world per capita, far ahead of the likes of the UK, increasing year on year…..
@Adam J: Uses PPP, they believe things are cheaper in Ireland so inflate the figure.
The real public health spend ( Pandemic excluded) is €16 billion divided by 5 million , or €3200 .
Ever read the story of the boy who cried wolf!!!
I listened into the debate. Thought Minister & Watt defended The progress on Slaintecare. We definitely are lucky to have Watt & Reid leading the Change! If the deliver they are worth every penny of salary.
@Anne C.: I seriously hope this is sarcasm!!
have your say