Who are the 'health Independents' and what do they want? Muiris Houston reports
Health may not have dominated the national election campaign in the way many had expected, yet at least six of the new Independent TDs were elected to the Dáil on platforms which highlighted local health issues.
The election of Dr Jerry Cowley in Mayo had been predicted; he was a comfortable winner and unlike some of the other Independents he did not have to endure a nail-biting last count.
In fact, Dr Cowley has been politically active since 1991 when he started a campaign to improve orthopaedic services in the county. As a GP in Mulranny, he was aware that some patients with serious fractures were faced with a 240-mile round trip to Galway for treatment. He actually declared his candidacy in a 1994 by-election but withdrew on foot of promises that phase 2 of Mayo General Hospital, to include an orthopaedic unit, would get the go-ahead.
Cowley also has a track record in looking after the welfare of the elderly and returned emigrants and is a long-time campaigner for a helicopter emergency medical service. In this election he also campaigned on broad infrastructural issues such as roads, improved communications and Knock Airport.
But it was to health issues that he owes a big part of his success, according to those who campaigned for him. His commitment to address the four-year wait faced by people with arthritis before they can be assessed by the Western Health Board's sole rheumatologist struck a chord with the electorate; the lack of urology services in Mayo General Hospital and the cutbacks in orthopaedic facilities as a result of the pressure on general surgical beds were other important issues.
Now that the election is over we are beginning to hear of budgetary difficulties within the health service; Cowley warned the Mayo electorate during the campaign of an existing €1.8 million overdraft at Mayo General hospital, with cutbacks in services likely to follow.
In Co Clare a one-time Fianna Fáil councillor, James Breen, highlighted the need to improve services at Ennis Hospital. The fact that he secured 20 per cent of the vote and was elected on the second count is an indication of the importance of health issues locally.
Finian McGrath, a former chairman of the Dublin branch of Downs Syndrome Ireland, campaigned on a broad range of social, health and environmental issues. His election on the sixth count in Dublin North Central may not have been solely on health grounds, but they undoubtedly played a part.
The results in Cavan-Monaghan produced an upset when Paudge Connolly was elected to the Dáil with 7,722 first-preference votes. A "hospital candidate" of the type we have seen in previous elections, he now has a mandate to seek the retention and development of Monaghan General Hospital. It has seen a cutback in maternity and paediatric services, and there are fears locally that it will be downgraded further as Cavan General Hospital is developed by the North Eastern Health Board.
In the south-east health candidates had contrasting experiences. Waterford Independents seeking local radiotherapy facilities polled in the low hundreds. In Wexford Dr Liam Twomey was elected on a platform which included the radiotherapy issue but was much broader. He wants to see cancer treatment services better organised in the region.
He follows the Irish Medical Organisation and Irish College of General Practitioners line on medical cards; an increase to cover 40 per cent of the population based on need rather than age group. And he and his supporters also campaigned on the development of Wexford General Hospital, mindful of the potential to downgrade it in the shadow of the region's other major hospital in Waterford.
While personally surprised at his election, he attributes his success to a 60-strong team who ran a coherent campaign in which they explained the issues in detail on the doorsteps.
So where to from here for the "health independents"? Jerry Cowley and Marian Harkin, elected in Sligo-Leitrim on a manifesto that included health issues, had a pre-election alliance based on common regional goals. They and others will form a loose grouping in the Dáil to focus on health issues. In order to maximise parliamentary benefits, they will probably join with the other Independents in an administrative alliance.
But unlike the three Independents who supported the Government in the last Dáil, they are unlikely to extract any specific promises from the next administration. In the hard world of realpolitik, they simply won't be needed.
Instead they are likely to focus on local health issues which directly affect their constituents. And the very local nature of these problems may be a factor which will work against them when it comes to collective action in the Dáil.
The election of so many candidates on local health issues sends a clear message to Government and to the health boards. People are hurting when it comes to local health services. They want something done about access, quality and fairness.
It will make it more difficult for health authorities to push through regional restructuring. The creation of centres of excellence, in cancer care, for example, may have to be more locally based that expert medical opinion recommends.
The success of the "health Independents" has certainly proved one old saying: all politics is local.