Cabinet divisions over future of healthcare a gift to Opposition

If yesterday's Cabinet meeting at Ballymascanlon did nothing else, it boosted the profile of Fine Gael and the Labour Party in…

If yesterday's Cabinet meeting at Ballymascanlon did nothing else, it boosted the profile of Fine Gael and the Labour Party in the health debate.

It was not, presumably, meant to be like that.

The meeting should, at the very least, have left the impression of a Government eager and ready to get to grips with a health system which needs a deep and detailed overhaul.

Instead, the Opposition has been handed the gift of being able to point to a sharp division of opinion in the Cabinet.

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That division of opinion would appear to have the Minister for Health and Children, Mr Martin, on one side and the Minister for Finance, Mr McCreevy, on the other.

Weekend leaks and Mr Martin's Morning Ireland interview left the distinct impression that the Government would announce something tangible after its meeting.

That Mr McCreevy was the first out of the traps at Ballymascanlon did not augur well for that point of view. His declaration that no decisions had been made and that the issue of health spending would be dealt with in the context of the budgetary estimates suggests Mr Martin has a fight on his hands and that Mr McCreevy has won this round.

This is not the first time that this impression has been given. Last year Mr Martin was declaring that the report of the Medical Manpower Forum was "the only game in town" in relation to medical staffing of hospitals.

But implementing that report alone could add £1 billion a year to the health bill.

Before its recent annual conference, the Irish Medical Organisation was alleging that the Department of Finance was opposing the report's recommendations on grounds of cost.

When the Minister subsequently addressed the IMO conference in Killarney he said, of the implementation of the report, "I will continue to do my best to provide the resources necessary to implement the reforms that we all want."

It was a form of words which suggested that financing the implementation of the report was conditional on Mr Martin's best being good enough.

Subsequently, the publication of the report of the Medical Manpower Forum took place with more of a whisper than a roar.

In one sense that doesn't matter: the details had been well leaked. The degree to which its conclusions were being talked about before it had even been published had become a bit of a joke.

When a report as big as this one is issued without the requisite ballyhoo, observers can only conclude the Irish Medical Organisation got it right.

There is a problem here, though, for those who oppose Mr Martin's costly plans for the health service.

Until the thousands of beds taken out of the hospitals in the 1980s and early 1990s are restored, public disenchantment with the health service is going to worsen.

Mr Martin's standing in the health sector is good. He is seen to have an unusual willingness to find out what is wrong and what needs to be done. He talks to people. He learns from them.

What the health sector is waiting to find out now is whether he can deliver on the various reports and strategies to which he has committed himself.

Yesterday was not a good day for him. It was a good day for an Opposition which, despite its policy documents, had not made much of an impression on the health debate up to yesterday.

One point of clarification: we are talking here about the Opposition outside the Cabinet.

Somehow, it seems necessary to say that.

pomorain@irish-times.ie