You've won the Sweepstakes - The outsourcing of responsibility in south Ireland.

When the saorstát was set up the new administration choose the least path of resistance when it came to the provision of a number of important services. Two fundamental services necessary for the development of a state where effectively devolved from state control - Education and Health. While there may have been a reason at the start to do so to allow this to continue for decades was a serious failure of State responsibility and helped create or perpetuate a state not able to identify its responsibilities and act on them.

Significant elements of Health care was provided by a mix of hospitals predominantly ran by the catholic church, with some few provided by the protestant churches and some intermittent, and resisted, state oversight. However while both voluntary hospitals resisted the state they accepted its funding as and when needed. The saorstat was naturally in a financially weakened state considering the turbulent times it had passed through. Due to a low population base and a weakened economy it had difficulty raising the necessary funds to support hospitals. The answer was the Irish hospital sweepstakes - a state monopoly on lottery i.e a gambling racket -  not that I dont have anything against a flutter but you'd think churches would. The sweepstakes was an okay idea in the sense that it managed to extend the funding of hospitals beyond the limited population of the saorstát with significant funds coming from abroad. It was a bad idea in that it was used to fund institutions which were not under the absolute control of the state but were the equivalent of privatised institutions. Mary Harney would have liked the idea - State money to support non-state monopolies of critical services.

The Sweepstake itself was open to all the flaws of a racket managed by Govts. (of both parties) with a penchant for handing responsibility to someone, anyone.  The American edition of Reader's Digest once described the Sweeps as "the greatest bleeding heart racket in the world". Many of the funds raised in America of Britain never made it back to Ireland but went into the pockets of distributors. But there was a more pernicious element to the Sweepstakes than that.

The story of the Sweepstakes has many parallels with modern Ireland. The Sweepstakes was set up with loopholes that allowed its organisers leave large sums undeclared as expenses. The impact of the sweepstakes started to spread to other sectors beyond the health. Soon directors of the Sweepstakes were to be found in every sector of the economy with some directors sitting on up to 30 company boards. Similar to the golden circle mapped by TASC a small group of men were taking control over every aspect of the economy. Apparently RTE had enough material in the mid 1970s to expose the deep concerns many felt about the Sweepstakes. It will surprise no one that RTE choose not to broadcast it. (How RTE can be made a neutral non-govt. controlled station is an important challenge for the future.)

The state failing to provide important services, instead relying on non-state institutions funded by state raised revenue, corruption and the misuse of state funds to gain control of wide sectors of the economy, a media gagged and incapable of reporting the truth. A decades long story unchallenged by FF or by FG.

Education is also another area where the state just mosied on glad that someone else was doing the lifting.  Currently about 90% of primary schools are patroned by the Roman Catholic church. These schools are privately owned, publicly funded institutions. Across the school sector the state is an outside party - there to pay the bills. The patron is not a figure head. They have ultimate responsibility for the school ethos, the appointment of the board of management, financial and legal matters and the supervision of staff appointments in accordance with Department regulations. Patrons generally discharge their responsibilities in close consultation with boards of management and other interested parties involved in the schools. In other words they have significant powers.

While the catholic church figures heavily in the outsourcing of Education as well this is not about the catholic church. Indeed there are many other denominations and of  course non-denominational schools. Similarly while in the Health sector there are some very objectionable acts by catholic denominated churches. (Notably in 2005 the board of the Mater Hospital in Dublin stopped a trial for a new cancer drug. Women who wished to take part in the trial could not get pregnant which obviously meant they had to use contraception or not have sex. This was in conflict with the ethos. Money from gambling was not in conflict with the ethos of hospitals though - but as horrible a story as that is I am not trying to focus on the catholic church here)


The main focus must be on the state's tendency to step back from taking responsibility for critical functions. While they may have reason to do so for a few years at the foundation of the southern state it was not acceptable to leave the situation continue for decades across two of the most important areas in which a state must provide services. To do so was to accept the principle that any service, no matter how critical need not fall under the Govt's direct and complete control. The Govt. became a partner rather than a leader. Rather than forcing the pace of change, modernisation etc. it just sat back and let society drift. Little surprise then that the current Govt. has provided little leadership in the financial crisis. Instead it has taken the Banks at their word, it has followed the interests of the developers and the golden circle rather than steering its own course. Commentators like David McWilliams and Brian Lucey have both wondered aloud about whose interest the Govt. is serving. At this point about 3/4 of the south's residents agree its not the Irish nation. But I dont believe that the Govt. could ever have done anything other than follow the Banks and the advice of the special interest groups even if they were not as delinquent as they have proven. The tradition of governance in south Ireland is not one of leadership but of relinquishing sovereignty to any group willing to take over some of its tasks.

Fianna Fail stand indicted as do Fine Gael on this point.

The final point on this abdication of responsibility I will leave to Professor Kathleen Lynch who recently gave the annual Tasc lecture. In a speech entitled From a Neo-Liberal to an Egalitarian State: Imagining a Different Future' she notes:

As a society, we do not have a strong commitment to public solidarity despite our rhetoric. This is reflected in failure over the course of the last 10 years for social welfare provisions to keep pace with the cost of living. We have one of the lowest rates of social expenditures on education, housing, transport and welfare within the EU. (See Tables 1 and 2 below using the SILC data). Our lack of commitment to the public sphere is evident in many concrete ways, from the lack of public spaces for play for children (especially safe indoor places) to the lack of public sports facilities, to the lack of investment parks and public amenities in so many towns and villages.

It is even evident in our churches. Most of our leisure and sports facilities are actually privately owned by clubs that are legally constituted as private bodies; GAA pitches, tennis courts, gyms, rugby pitches, golf courses etc. are all private. Indoor play areas for children are almost universally commercial. And the lack of commitment to the good of the public sphere is evident when public and private interests collide; it is evident in the way space is organised and the quality of the built environment between public and private hospitals, in the relative luxury and comfort of private rooms versus public wards; it is visible in the pitches, tennis courts and other facilities in well-off schools compared with the bare yards of small fields that are there for those in less-well-off or poorer areas.

No country for old men

They say that you can judge a society by how it treats its young and its old. Last week with evidence that 188 kids died while under HSE care or remit it was clear that kids were not well served. Its the turn of the old this week with old people in a resident's home being pressured by the HSE to relocate. With the pressuring and threatening of old people the HSE shows how morally bankrupt it is.

Sinn Féin Councillor Paul Hogan has called on Health Minister Mary Harney to intervene after a third resident of Loughloe House has died since the HSE's announcement on 6 May of its plan to close the home. He described the tactics being used by the HSE to relocate residents as despicable and disgusting.

Councillor Hogan said: “A third resident of Loughloe House has passed away today. She had suffered a stroke in Loughloe House after pressure was put on her to agree to move to another home. She was transferred to Mullingar Hospital where she died in the early hours of this morning (Tuesday).

“Two residents of Loughloe House died within a week of the 6 May announcement. Relatives and staff with whom I have spoken are in no doubt that the stress caused by pressure to move out of Loughloe House was the key factor in their untimely deaths.

“Two other residents had heart attacks and another man had a stroke. Six people have now been hospitalised, three fatally, in one month. I want to extend sympathy to the three families concerned.

“We are talking about people’s lives here. Something needs to be done. I am calling for the Minister for Health Mary Harney to directly intervene and stand down the HSE’s disgusting and despicable methods of relocating residents. As Minister for Health she has a duty of care for all residents of Loughloe House.

“I have also called for an independent investigation into the methods being used by the HSE to relocate residents. Some residents have been threatened with the street if they talk to media or public representatives. Some were threatened with the door if they refused to take another bed offered to them by the HSE.

“Today I am meeting Joe Ruane, Health Manager for Longford and Westmeath. This will be my third time to meet him since the announcement was made to close Loughloe House. I am also meeting Minister for Health Mary Harney tomorrow in Leinster House. I will be raising these matters with them in a compassionate plea to stop the HSE from using such tactics, which is obviously causing huge stress and anxiety amongst the residents.”

A Master class in spin

Today was a fairly normal day in Ireland. Nothing of note really happened did it!

Certainly nothing happened in comparison to the terrible news thats coming out of Haiti.

On every newspaper, television and radio station there is going to be wall to wall focus on the disaster. And we will all watch it. Not out of a morbid desire or some strange car-crash voyeurism but because as normal people we will watch this and feel a deep empathy and sorrow for the suffering of other people.

You'd think that most people would think the same. Well unfortunately they dont. Some people look at this as a useful disaster and they think every cloud has a silver lining.

Looking at BreakingNews.ie I was struck by a series of related posts.


At 12:25 Minister Mary Harney "announced the roll out of a bowel cancer screening programme which kills around 930 people here every year."

Hmm! Fair play the Govt. Doing the right thing. I am impressed.

But wait...there is more:

At 12:32 Mary Mary strides once more across the media like a colossus with another missive:

"The Health Minister has today announced that she is reversing the decision not to roll out the cervical cancer vaccine for secondary school students."

Oh! So they climbed down did they. But at least they are also doing the right thing. And so rather than this being a craven climb down we know have a positive cancer detection strategy. Rather than caving we now have Harney the leader. Aint she the bomb.

That this "leadership" was on the 1:00 news did no harm to Harney or the govt. A climb down became a positive and a problem was neutered. Best of all nobody was going to focus on this too much. Because of Haiti it was just accepted and the news moves on.

Next it was the turn of fellow Fianna Failer John Gormley.

No sooner was the 1:00 clock news show over than John boy was ready to roll. There was just enough time to make the tea and do the dishes after Dinner before he started his bit.

At 14:23 modernising John confirmed that "Dubliners will directly elect a Mayor this year.Environment Minister John Gormley has announced the capital's citizens will go to the polls in June. The job will command the same salary as a Government minister."

Who could not be impressed. This was the Greens as they want us to see them. The party modernising the southern state's dated institutions by coming up with a trendy Mayor idea. I was in awe but John didnt stop there. He was on his bike ...


At 14:46 decisive, honest, reforming John came out "to limit junkets for Councillors. Green Party leader John Gormley says he is determined to end the "abuse" of Councillors attending too many conferences."

Thats the kind of Greens we wanted to see. The Greens we once believed in etc etc. I could almost see myself voting Greens at the next election. Their story was beginning to get some traction at some level.The Greens love pretending they are a modernising force. And today they piled it on trying to get that message into our head.

But the coup de grace was at 18:25 because at that hour Breakingnews.ie reported that "Ireland is sending 80 tonnes of emergency supplies to Haiti following Tuesday's devastating earthquake.The aid will be distributed to 8,000 families through charities Concern and GOAL who are working on the ground there."

And thats only right and good to see but wait whats this at end:

"Some 35 members of the Government's Rapid Response Team are also on standby to travel to the stricken region."

The Governmant's Rapid reaction force? Excuse me? Who the hell is that? Or do they instead mean the southern Irish state's rapid reacion force. Because by christ whats it got to do with the those parasites sitting around the cabinet table. Still, pile it on! If it makes the govt. look good they'll do it.

Today Mary Harnney and John Gormley took advantage of a disaster to stack their messages so as to command attention at news time. Nothing could compare with Haiti but by stacking the messages they could command some air time and sell their messge to the people. Mary turned a negative into a positive and Gormley used today to reboot his parties image and once more push out the message that the Greens are reforming and modernising.

Is this nasty. Yeah of course it is but by god they are slick operators.

Today was a master class in media and ultimately voter manipulation.

Link Backs: Political Messages

Sinn Féin in the North demands answers and action on health cuts

Here is an article from this week's an Phoblacht addressing the issue of proposed cuts to the health service in the 6 counties.

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DESPITE assurances from the North’s Health Minister, Michael McGimpsey, that “efficiency savings” in the Department of Health would not impact on frontline services, he has approved proposals to cut hundreds of nursing positions, remove beds from hospitals and drastically reduce ambulance services.

There is growing anger among health and social care professionals, trade unions and the broader community as the cuts threaten to seriously erode the quality of care in the North’s healthcare system and attack the rights of health workers.

Trade unions are discussing plans to take industrial action against the cuts and Sinn Féin is urging everyone concerned about the cuts to join the public rally in support of the health service and workers in Belfast on Friday 6 November at City Hall.

The British Treasury in London has demanded that the Department of Health makes £700 million in cuts (so-called “efficiency savings”), over three years. The Comprehensive Spending Review (CSR) announced by the British Government is ostensibly aimed at reducing bureaucracy and reinvesting funds into frontline services – but in reality it is simply cutting public funding to the health service.

The North’s six health trusts are currently bringing forward proposals to the minister on how they plan to achieve their saving targets. The CSR set a 3% reduction target in the North’s health department and has led to the recommendation that almost 3,000 jobs be cut in the Belfast area alone. On top of the funding cuts, the trusts face a combined end-of-year deficit of £76 million.

Speaking to An Phoblacht this week, Sinn Féin MLA and member of the Assembly’s Health Committee Sue Ramsey said several crucial issues had been raised by the proposals made by the health trusts and the department, including the impact on the health of the community and the livelihood of staff employed by the trusts.

“These proposals will lead to a crisis in the North’s health service, which is already under strain,” Ramsey said.“We are also concerned about the lack of transparency and consultation in the process through which the proposals have been made and approved.

“It is time for a clear policy change. So-called efficiency savings are affecting frontline services and local people’s health provision. We can no longer check cuts to health services through the current framework. It is simply not working.”

HITTING FRONTLINE SERVICES

The Belfast Health and Social Care Trust, the largest trust in the Six Counties and employer of 22,000 people, has been directed to cut 9% of its spending, or £130 million, by 2011.

When the CSR’s drastic proposals for cuts provoked a public outcry in 2007, McGimpsey insisted the proposals were not policy and that frontline services would not suffer. However, the Belfast Trust has brought forward many of the exact same proposals, which have now been approved by the minister.

Some of the cuts proposed include:–
1) An estimated 925 administrative jobs, 450 social services positions and more than 722 nursing jobs are to go by 2011 under the proposals approved by the Health Minister.

2) Ambulance provision across the North may be cut by 70,000 hours.

3) 152 beds are to be cut at the City and Royal Victoria Hospital in Belfast next month.

4) The Belfast Trust last month suspended the referral of patients to the private sector for operations, which had previously been used to shorten waiting lists. The trust paid for 7,000 private operations last year and commissioned another 4,000 this year before the suspension.

5) Mental health provision beds are also coming under pressure, with one of four wards for older people in Knockbracken Hospital in south Belfast being considered for closure.

Other actions that have been proposed include a greater reliance on a ‘skills mix’ within the medical profession – that is, relying on less-qualified healthcare workers to carry out the work of nurses and midwives to cut costs. The Belfast Trust additionally plans to ban staff overtime and stop all use of agency nurses.

There is also a push to have patients stay in hospital for the shortest time possible, including those who have undergone surgery. Women’s health professionals have expressed dismay at the Belfast Trust’s plans that new mothers be released from hospital just six to 12 hours after they give birth.

‘UNACCEPTABLE’

Commenting on the proposals, Sue Ramsey said the Belfast Trust’s ‘efficiency saving’ proposals were “unacceptable and unsustainable”.

“These proposals are supposed to free up resources to be reinvested in frontline services but you cannot get more frontline than the ambulance service, the targets of the cuts,” she said.

“Similarly, the backbone of the health service are its nurses – cutting more than 700 nursing positions would not only impact on the quality of care provided, it will place enormous pressure on the remaining nurses.”

The Sinn Féin MLA argued that these proposals essentially try to shift responsibility for medical care provision onto the already strained community sector to cut costs.“While the community sector plays a vital role in health and social care, medical care must be provided by fully-qualified medical professionals.

“And while these so-called efficiency savings are supposed to be reinvested into frontline services, there is no guarantee or mechanism to ensure this is the case.”Discussing the impact the cuts would have on health workers, Ramsey said the Belfast Trust’s plans to stop recruiting new staff, ban agency workers and overtime would impact on the most vulnerable and lowest-paid health workers.

“Clerical staff on agency or temporary contracts are already without maternity cover, holiday leave or pension entitlements,” she said. “I want to know how this strategy has been assessed against the trust’s legal duty to promote equality.”

Ramsey told An Phoblacht there is also anger among the Assembly’s Health Committee and trade unions due to the lack of transparency and consultation on cutback proposals before their approval by the Health Minister.

“I have submitted questions to the minister about the Belfast Health Trust. When did they first know about the proposed cuts to staff, facilities and services? Who else knew about these cuts? Why did they not bring these cuts to the attention of the committee or others before they began to impose them?”

HEALTHY COMMUNITIES

The Sinn Féin MLA said there are “undoubtedly” real efficiency improvements that could be made in the health service, such as addressing high levels of bureaucracy, top-heavy management and outside consultancy fees.

Sinn Féin has called for the comprehensive Investing in Health strategy proposed by Bairbre de Brún when she was Health Minister to be implemented as a way to strengthen the health service and integrate it with other departments and social agencies, such as housing and education bodies for example.

“This strategy has the potential to save millions of pounds in the health budget by taking a holistic approach to preventative health care,” Ramsey explained.“All Government departments, agencies, social partners and community organisations must realise that to invest in health will transform our society and cut down on expenditure on treating preventable illnesses.

“Ultimately, these proposals are being driven by the British Government’s agenda of privatising and attacking the public health service and other public services,” Ramsey said.

“Sinn Féin proposed during the first session of the Assembly that we should have tax-varying powers so that we could raise taxes if needed for essential services; however, all the other parties opposed this.

“The scale of the crisis being unleashed on the health service demonstrates sharply the need for decision-making powers about the economy to be in the hands of locally elected and accountable politicians.”