Fixing the HSE is a major operation and Reid will need billions to do it

On that wall, in the HSE headquarters, a former hospital across the road from Heuston Station, there is a message from each HSE employee: They say hi’ give their first name, and then a line about themselves, such as: “I love walking and photography”; or “I’m a new mum”; or “I’m a good listener”; or “I’m a U2, Michael Buble, and Dubs fan”.

When he tweeted the photo of these headshots, Mr Reid, their boss, added his own take, by saying, “And yes…we are all humans in Dr Steeven’s in @HSELive. We know that we haven’t got our #OurHealthService sorted.

But we are committed and are working hard to do so.” What a job that man has. You wouldn’t envy him it.

Last year, Health Minister Simon Harris, in a Cabinet memo, described the HSE as being “too big to fail and too big to succeed.” Yet we all need Paul Reid, very badly, to succeed.

We have become so inured to the unravelling of so much of our health service that we simply factor it in as part of the deal now.

But if there is one thing we, as voters, must do in this upcoming general election, it is to up our own game in asking, nay, demanding, that our politicians present credible plans, and properly funded, for sorting out the health service.

At the beginning of this week, in a further post, Mr Reid commented on a news report that the size of the HSE, at central level, is to be scaled back and reformed and will have fewer staff.

There was mention of “a tighter and more focused centre”, in anticipation of the new regional health bodies planned under the Slaintecare health reform plan.

Just how this will come about we do not yet know (redundancies would have to feature), but, certainly, the notion that the number of HSE “pen-pushers” is to be reduced wins almost universal favour.

“Our priority has to be to the public and all who use our services,” said the HSE chief in his tweet. So he has to humanise his staff, make people believe they are trying their best, but also make a number of them redundant.

Looking at it from the outside in, Mr Reid, appointed in April, appears to be going at things rather well so far. He’s consulting widely, attempting to build up credibility, reaching out to the professional bodies, and recognising and highlighting what needs to be done.

But when one considers the magnitude of what the former chief executive of Fingal County Council faces, it is impossible to imagine him succeeding, unless the next Taoiseach personally commits a whole of government approachto it.

For instance, will the political parties say anything in their manifestos about the need to shut down acute services in various places?

This will be necessary under the current government’s plan for six regional health authorities overseeing hospitals and community services at local level, but would drive local politicians bonkers.

What sort of electoral commitment/discussion will there be regarding the finances needed to get rid of our hugely unfair,two-tier health service? Would €2bn or so be needed?

Last week, Dr Donal de Buitléir, who chaired the independent review group that examined the removal of private practice from public hospitals (a central element of the proposed Sláintecare reforms), appeared before the Oireachtas health committee.

Most people see the massiveinequality in our public/private divide, but for those who can afford insurance cover, it is an attempt to try to protect themselves and their families from waiting lists and lack of access.

Dr de Buitléir told the committee that almost 30% of activity in Irish hospitals was funded privately, “a situation comparable only to the US”.

It seemed to him unacceptable that people are treated differently, and he gave an excellent example of what happens in practice. “My daughter is in primary school. Would anyone think it was sensible if I could pay the teacher extra money to give her special attention in the class, compared to other kids?”

It would be “technically feasible,” according to his report, to end the practice of private medicine in public hospitals, but it was now a question for the political system whether this proposal should be implemented.

Taoiseach Leo Varadkar is a former minister for health, so has a better understanding of the problems than most people do, but there is not too much to indicate that he is the man for this job. He talks a bit of the talk on health, but never gets his hands dirty in assisting the health minister with carrying the load.

It is only a matter of time before the aforementioned minister tells us that if he gets back into Cabinet, he will inform his Taoiseach that he is mad keen to get back into the health portfolio. We’ve been here on a number of occasions.

Anyone with Minister Harris’s best interests at heart would tell him privately that he needs to run like hell out of there to protect his political future.

It would be different if there was the prospect of proper, full Cabinet support and a Taoiseach who would tell him that might and main would be utilised to get hold of the few billion or so necessary over a decade to get rid of the apartheid in our health system.

You’d imagine a man with Paul Reid’s experience would have sought assurances of political support and action before he took up his new job.

But if we express to canvassing politicians, when they knock on our doors, our concerns about the state of healthcare in Ireland, that will give Reid further assistance.