Promising billions to build hospitals is seen as an election vote grabber, but the reality is not so simple, writes Alison O'Connor
The image of the Fine Gael leader, Mr Michael Noonan, standing in a wing of Monaghan Hospital which was devoid of beds and patients provided one of the strongest images of the election campaign so far. He described it as a monument to Government incompetency.
Health is one of the Government's more vulnerable spots and Fianna Fáil was quick out of the traps with a rebuttal.
Former Minister for Health Mr Brian Cowen said at the Fianna Fáil daily briefing yesterday morning that the only monument to Government incompetency he saw in Mullingar "was the man doing the talking".
Apart from the sniping the matter highlights a pressing issue which will face whoever is returned to Government. How much needs to be spent on capital spending to bring the health services up to scratch; and when does it need to be spent?
Fianna Fáil have pledged to spend €4.6 billion over the next five years, compared to Fine Gael's figure of €1.5 billion over the same period.
Fine Gael defends the smaller figure by arguing that it is not feasible to say you would spend such a large figure in that space of time and that it would end up being unspent as had happened with the National Development Plan when large sums were returned to the Exchequer.
Fine Gael point out that it would take years to provide the infrastructure and staff for the thousands of additional hospital beds planned. They say reform is needed to ensure that further money is not wasted and a capital plan that will take a number of years to get it up and running.
This argument was rebuffed by the Minister for Finance, Mr McCreevy, yesterday. He said spending the money in the Government's capital health programme was not a problem.
The process introduced by the Government where the Department of Finance allowed multi-annual budgeting meant that planning beyond the year ahead was now possible.
"Whatever difficulties there have been with the National Development Plan in other areas this has not been a problem with health spending."
The Labour leader, Mr Ruairí Quinn, agreed with the Fianna Fáil estimate of how much money was needed to spend on capital health projects but not the time frame. Labour believes it should take place over 10 years.
He said that front-loading the expenditure was extremely inefficient.
Anybody who has ever had building work carried out at home, he said, knows that if you are in a rush with the job you will not get good value for money.
The slow pace of change in the health services was highlighted yesterday by criticisms over the delays in implementing plans for the national breast screening service. The Minister for Health, Mr Martin, defended it saying structures in the health boards were not "attuned" to the recommendations from the report carried out into the service.