Game Of Thrones In Irish Healthcare

Perhaps the most striking aspect of the new government ministerial line-up is Simon Harris getting appointed to the Health ministry, and Varadkar getting moved into the Department of Social Protection.

In certain respects, as far as the health system is concerned, this is not much of a change for most people: akin to replacing Joffrey Lannister with Ramsay Bolton. For Varadkar it is obviously a demotion. But why did it happen? Perhaps some at the top of Fine Gael resent Varadkar’s relative popularity and self-promotion, and this was a means of softening his cough.

A more weighty factor, I imagine, is the anticipation that Varadkar would prove more of an obstacle to pressing ahead with further privatisation of the health service, which has been signalled in the programme for government.

It is not that Varadkar himself is ideologically opposed to such privatisation, but he does have medical training and perhaps has some understanding of the practical and technical problems involved in running a health service, and such an understanding is in itself an obstacle (some people have mentioned to me that his grasp of these matters is nonetheless far from impressive). If you understand what people are telling you, you are more likely to take them seriously. As a health minister, his public interventions on issues with the health service were bathed in an insouciance that masked an overall impotence.

Harris, on the other hand, has no such training, and has shown himself to be the most willing of servants to both the speculation community and Fine Gael’s top table. He is likely a safer pair of hands when it comes to glossing over what are failures from a public standpoint but successes from a private one: you need someone who is able to ignore actual medical concerns and focus on failures (which, when not engineered, have been invented through arbitrary financial targets that bear no relation to medical needs) in such a way that private entities taking over the running of things appears like a resolution.

Meanwhile, the promotion of Harris and Pascal Donohoe -ever ready to stick up for Fine Gael in the face of opprobrium on the likes of the Vincent Browne show- is a sign to the Fine Gael backbenches that obedience and pulling on the blue jersey will bring rewards.

There is another dimension, however: let us recall that former Fine Gael Health Minister James Reilly failed to secure re-election in Dublin Fingal, whereas his party colleague, Alan Farrell, actually improved on his vote while winning re-election. Reilly topped the poll with 10,178 first preferences in 2011, and shed over half of these votes in 2016. Meanwhile Farrell increased from 5,300 to 7,500. Part of this has to do, one imagines, with the fact that Reilly’s base of support was further north, among communities hit worse by the Fine Gael-Labour government, whereas Farrell’s support comes from the more affluent Malahide area. But the crucial distinction between Reilly and Farrell, in policy terms, was that Reilly had called for a repeal of the Eighth Amendment. It is hard to tell how much of this came from genuine conviction and how much came from a need to appeal to people who would be voting for Clare Daly. But Farrell, on the other hand, like Fianna Fáil TD Darragh O’Brien, who topped the poll in Dublin Fingal, had adopted a strong position in favour of forcing women to give birth.

As noted the other day, Simon Harris had previously made his ‘pro-life’ position clear, before subsequently declaring that he would favour changing abortion legislation to allow for cases of fatal foetal abnormality. In the eyes of the Fine Gael leadership, which of the two figures would be more likely to placate Fine Gael’s ‘pro-life’ constituency? Varadkar, popular among liberals for his prominence in the marriage equality referendum, or Harris, who sounds like he might lead the pilgrimage flight to Lourdes in another decade of the rosary, or a sing-song of Rock n’ Roll Kids? Let us not forget, moreover, that some of the major backers of the ‘pro-life’ campaign in Ireland have major stakes in the private health business.

Meanwhile controversy has been brewed in the early days of the new government on account of Sabina Higgins’s public declarations that forcing women to go full term in the event of fatal foetal abnormality was an ‘outrage against women’, with ‘pro-life’ campaigners objecting in characteristically mendacious terms, on the basis that the spouse of the president should not intervene in public affairs. No such objection arose from these quarters when Martin McAleese went golfing with the UDA, or when he was appointed a senator by Enda Kenny, or when he was then appointed to lead the inquiry into the role of the State in the Magdalen Laundries. Of course the fact he was not a woman, and not some sort of red either, had nothing to do with it, I am sure.

This all may appear grim, but I don’t think such moves come from a position of strength, but rather from a sense of urgency that time is running out, in the face of public resistance, for a regime that has long sustained itself through denying both a universal right to healthcare and the right of women to bodily autonomy.

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