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| Micheal Martin’s Troubles |
17 January 2003 |
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Martin is under increasing public pressure. Just before Christmas, the Parents for Justice group claimed he was unfit to serve as minister. They were angry at his refusal to hold astatutory inquiry into the organs retention scandal.
Micheal Martin was spoken of as a future leader of Fianna Fail not so long ago. But his fortunes have faded – to the apparent delight of some of his cabinet colleagues? Or are senior people in Fianna Fail out to damage him? By Mairead Carey
 The Minister for Health, Micheal Martin, faced a stark dilemma early in 2001. At the centre of it were Ireland's long-suffering haemophiliacs. Martin had been informed that there was a worldwide shortage of synthetic blood-clotting agent. This is the safest but most expensive version of a product that is vital for haemophiliacs. Martin wanted to keep what was left for children who had never been exposed to HIV or hepatitis C.
Those who had already been infected would have to return to using riskier blood-based products, however. The department had two options on this score, and neither was very appealing. The state could either buy supplies from the US, the source of products which had been responsible for killing over 70 Irish haemophiliacs in the past, or it could turn to Europe where there was (and still is) an unquantifiable threat from variant CJD.
Micheal Martin called in the Irish Haemophiliac Society. A decision was made. Adults with Factor 8-type haemophilia were put back on the US supplies — a situation which continued for almost a year. It was the safest bet. Correspondence released under the Freedom of Information Act last month showed that the Department of Finance had demanded the use of the cheaper blood-based products in any case, but for different reasons. The mandarins were keen to satisfy the need for cutbacks. The welfare of haemophiliacs didn't feature in the memo from Charlie McCreevy's office.
The letter stunned not only the haemophiliac community but many in the health service itself. The state is still paying the price for its penny-pinching on blood products in the 1980s, Hundreds of millions of euro have been paid out in compensation, legal bills and ongoing medical expenses for those who contracted Aids and hepatitis C. Putting haemophiliacs back on cheaper blood based products would expose them to new dangers and, in so doing, had the potential to make the state liable for massive costs.
Martin is adamant that he would never expose haemophiliacs to unnecessary risk for monetary reasons. The letter from Finance, according to sources close to Martin, highlights that department's ignorance about health matters. Despite years of debate over the blood scandal, and a tribunal of inquiry into how it happened, the Corkman's allies suggest. Finance still hasn't learnt that you can't compromise on safety.
The correspondence was only part of the ongoing and very public battle between the two departments over funding. It also represented an intensification of the political trench warfare in which Martin and some of his cabinet colleagues seem to be engaged.
At an extraordinary press conference to mark the publication of the book of estimates in November, Charlie McCreevy repeatedly dumped on Martin.
Michael McDowell soon joined in the fray. Within weeks of Martin giving a commitment in the Dail to hold an inquiry into the role of US drug companies in the blood scandal, the Minister for Justice told reporters that the government "should not simply rush into action to appear to be doing the popular thing when it could be a monumental waste of resources."
McDowell also sprang to the defence of Judge Alison Lindsay for what he described as a "careful, well-balanced and measured" report. Micheal Martin's reaction to the Lindsay report was seen as lukewarm at best. His decision to publish the personal testimonies of the victims was in stark contrast to Lindsay, who devoted just four pages of her 577-page report to them.
It would, however, be too easy to paint this as a battle between 'Nice Guy Micheal' on one side and ruthless cabinet rivals on the other. Nothing in politics is so simple. McDowell and McCreevy may have gone public with their grievances, but there are plenty of colleagues who express private disquiet at the way Martin handles his portfolio. At the time of the estimates debacle, government sources suggested that McCreevy had come under pressure from other cabinet colleagues to rein in Martin.
"Micheal has gone native," one senior source told Magill. "He defends the indefensible. Of course, he's a grand man and everyone likes him, but the way his department is functioning speaks for itself. There is something seriously wrong when spending goes from €3.6 billion to €8.3 billion and the service actually deteriorates."
This person points to the report of the so-called 'three wise men' — the cutbacks committee headed by the former governor of the Central Bank, Maurice O'Connell. They singled out the Department of Health for special criticism and said that the rate of growth in health spending "simply cannot be sustained". Tough decisions would have to be made by the minister, they suggested. "It is essential that this point is understood so that public expectations about the scope for continued expansion in the health services can be moderated," the committee noted.
"Micheal caves in to everyone," says another insider. "He empathises with them all, but you can't be liked all the time. The problem with the Department of Health isn't money. It's all about management. And Micheal isn't managing his department. He's getting €9 billion and there is still a perception of a crisis."
Martin is under increasing public pressure. Just before Christmas, the Parents for Justice group claimed he was unfit to serve as minister. They were angry at his refusal to hold a statutory inquiry into the organs retention scandal.
On the same afternoon, Martin held a two-hour meeting with Jimmy Livingstone, whose pregnant daughter was turned away from Monaghan Hospital with tragic consequences. Her premature baby was born en route to Cavan Hospital and died three hours later. Livingstone said publicly that he held Micheal Martin personally responsible for what happened to his daughter. Just a few weeks earlier, health campaigner Susan Maher was killed as she drove her child home to Kilkenny from sign language classes in Dublin. She had got up as usual at 4.30am to make the journey with her five-year-old son Bobby. It is thought that she may have fallen asleep at the wheel as they returned that night. Her car veered off the road, landing upside down in a swollen stream. By the time the emergency services arrived, Bobby was suffering from hypothermia. The mother of six was dead at the wheel. They were seven miles from home.
Susan Maher had met the minister two years before her death. She was assured that speech and language therapists would be provided for deaf children in her area, and that funding would not be a problem. The Bacon Report, commissioned by the department 18 months ago, recommended an increase of 350 per cent in the number of speech therapists nationally. Health workers say the numbers have decreased since then. Susan was compelled to continue to make the journey.
Micheal Martin went on to earn the wrath of his own constituents over Christmas when his department was seen to be haggling over compensation with a young hepatitis C victim as she lay critically ill in a Cork hospital. A package had been agreed upon on December 2, but had not been finalised. The department eventually agreed on Christmas Eve to sign off on the package for Sylvia O'Leary. Had she died beforehand there would have been no legal obligation on the state to pay up. The delay was attributed to the Attorney General's office and the Department of Finance. All of these things have severely eroded the Health Minister's popularity.
"There is enormous anger amongst the general public. They see that the money is going into health, but it's not working for people on the ground," says Fergal Bowers, editor of the health website, Irishhealth.com.
"The government promised progress on the waiting lists, but there are now 29,000 people waiting to be admitted to hospital for treatment compared to 24,000 a few months ago. People are facing higher health insurance charges. You have the laughable situation where they brought in a treatment purchase fund of €25 million but only €7 million was spent — the rest was clawed back.
"The national health strategy which was published only a year ago has already been described by the Irish Medical Organisation as a dead duck," Bowers continues.
"Next year we are looking at job cuts in the health services when the plan promised increased spending over the next ten years. Reform is crucial but it needs real political steel. It remains to be seen whether there is the political will to implement it."
Just a few years ago, Micheal Martin could do no wrong in Fianna Fail. The former schoolteacher was seen as the squeaky clean hero who would bring the party out of the era of tribunal-related sleaze. These days, many in the party refer to him as 'the former future leader'.
While Brian Cowen has a very visible block of support in the parliamentary party, Martin has a far more timorous fan club — that is, if such a group exists at all.
"He's not one of the lads and as a result some of the backbenchers think he's aloof," says one senior party official. "He dispenses his friendliness in equal measures, but isn't particularly close to anyone."
The story for Cowen is very different. "Cowen's people are there for him," says one backbencher. "Fellas are only waiting for the off to back him, and the funny thing is that he has to do nothing to get that support. He doesn't have to plamas anyone. He just has to be himself."
Many government ministers have formed strong alliances down through the years. Martin has not done so to the same extent, and recent changes in the make-up of cabinet have also been to his detriment.
"In the last government, Mary O'Rourke, Michael Woods and Micheal Martin formed an axis," says one senior Fianna Failer. "They had a more left-leaning bent. They believed in social inclusion. But those days are gone. We are looking at a far more right wing government and, as a result, Micheal is more isolated," says one senior Fianna Failer. "They are out to gut him."
"In cabinet, Micheal is the one they would all like to see tripped up," another party source confirms. "He has so much money, so much publicity, that they would love to see him get his comeuppance. Bertie would not be alone in that."
Indeed, Ahern is seen by many of Martin's supporters as the man behind the Health Minister's troubles.
"There is a whispering campaign coming out of government buildings, which is really a compliment to Micheal Martin," says another insider. "People around Bertie are having a go, because they are insecure for the Taoiseach. They think he's in difficulty. Bertie's gloss is gone. The public are lukewarm towards him. The best way to draw the flak away from him is to put down those against whom he may look bad."
While Cowen may be the bookies' favourite to win if there was a leadership contest in the morning, no one could write off Micheal Martin. What he does during the rest of his tenure at the Department of Health may well decide his fate.
One of the crucial issues on which he will be judged is reform of the health boards. Instead of reducing their influence, he has increased their number to 11. This flies in the face of the 'three wise men' report, which expressed "serious doubts" about the efficacy of the existing health board structures.
Tackling the health boards, however, would mean taking on the county councillors and minister's nominees who make up their membership. If Martin deprived these people of their generous travel and attendance expenses, he would not ingratiate himself with the Fianna Fail grassroots, even if it did help him to meet cutback targets.
"Micheal Martin has been damaged by the portfolio he was given, and maybe that is why he got it. But he can restore his position if he makes radical changes rather than tinkering around with a system that doesn't work," says one Fianna Fail backbencher.
"He has to eliminate the bureaucratic monster that is the health boards. He has to look it straight in the eye and deliver change. They are a complete waste of public funds. It may be unpalatable, but they have to go."
Reports calling for such radical reform are piling up in the Department of Health. Value for money is the hot phrase in Fianna Fail, and a report of the same name carried out by Deloitte & Touche last year found major failings in the way Martin's department and the health boards carry out their work.
Despite the report, Martin refused to abolish or amalgamate the health boards. He also refused to accept that they were top heavy with administration.
The latest report on the issue to land on the minister's desk also advises radical reform of the health boards. The report, drawn up by the Chief Executive Officers' Group, recommends fewer political representatives, smaller boards and representation from specialists. Yet another report is due in January. The Commission on Financial Management and Control in the health services will again put pressure on Martin to reform the system. The Commission is being chaired by Prof Niamh Brennan, the wife of Michael McDowell.
Micheal Martin is reputed to have been reluctant to stay on at the department his predecessor dubbed 'Angola' after last year's general election. His friends say he would have liked to take charge of another portfolio such as transport or enterprise and employment.
But, for all that, there is no getting away from the fact that health accounts for almost a quarter of all government spending. It's a department which can make a direct difference to people's lives and Martin apparently believes he still has "unfinished business" there.
How he deals with that business — along with how he deals with the backbiting of so-called colleagues — will be the making or breaking of him. |
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