A Galway doctor and Western Health Board member has accused the Minister for Health, Mr Martin, of lacking the political courage to reform existing health board structures.
Dr Martin Daly, a general practitioner in Ballygar, Co Galway, and treasurer of the Irish Medical Organisation, said yesterday that there were too many regional health authorities, and gross duplication of resources. He also questioned whether effects on patient care could be minimised when the health board was seeking 200 job cuts.
"Doctors, nurses and paramedics recognise the need for proper administrative back- up," he said. "The problem is that every time the Department of Health or a health board lays its hands on a scheme, the system becomes more important than the people involved and it becomes over-bureaucratised."
Dr Daly said he did not agree with total abolition of the health boards, but there was definitely room for rationalisation. "For instance, we have nine different computer systems for the childhood vaccination scheme among the 12 authorities, and that is a stark example of the complete inefficiency and territorial nature of the health board structure.
"Yet, in spite of this computerisation, when we had a crisis like the recent one with the polio vaccine, the Department didn't have proper records. Why do we need 12 of these authorities in a country of this size?" he said. "It seems to be almost a sinecure for local politicians, and there is a reluctance on the part of the Minister to address this in case he might be treading on these people's toes."
Dr Daly said it was "very easy to be a good minister in good times" - and Mr Martin had not been particularly good in his view. "The mark of any minister is his ability to reform existing structures. Instead, the Minister has been taking the soft option.
"We have had denials of cutbacks, and a most despicable black propaganda campaign against junior doctors during the recent dispute in Waterford," he said.
"If the Minister applied some of the energy he uses on spinning to actual reform, it would be energy better spent."
The Mayo Independent TD, Dr Jerry Cowley, has already called called for abolition of the health boards. " If there are to be cuts, I would question the 30-strong membership of the health board, with all of those people getting travel allowances, mileage and subsistence," he said.