Madam, - Noel Whelan calls for "something akin to the Tallaght Strategy, or the more recent cross-party approach on Northern Ireland policy" in relation to the current controversies over health policy (Opinion & Analysis, December 1st). Other commentators have made comparable suggestions. The Minister for Health made a similar call during the recent Dáil debate on the confidence motion.
There are no relevant parallels between the current controversies on health service delivery and either the Tallaght Strategy or the approach to Northern Ireland issues.
At the time of the Tallaght Strategy, it had become clear that the basis for a consensual approach on overall fiscal strategy was in place. When the Fianna Fáil government presented its budget after the 1987 general election, it was clear that it had dropped the main planks of budgetary policy which it had advocated during the election in favour of an approach which closely mirrored the Fine Gael proposals which the Labour Party had rejected at the beginning of the year.
The important thing then was to ensure that Finance Minister Ray McSharry had the support necessary to continue with a set of policies which had already begun to produce positive results for the country (inflation had been successfully brought under control, the trade balance had been positive and improving for over two years and the economy had regained competitiveness).
By the time the final phase of negotiations on the Good Friday Agreement got under way, the effects of Charles Haughey's rejection of the outcome of the New Ireland Forum had been overcome, as had the effects of Mrs Thatcher's ill-judged outburst about the Hillsborough Agreement. Charles Haughey himself had been in close contact with intermediaries in Northern Ireland, making it possible for Albert Reynolds, John Bruton and Bertie Ahern to keep moving forward.
Fianna Fáil had finally accepted that Articles 2 and 3 of the Constitution stood in the way of a peaceful and politically workable agreement.
There is today no corresponding level of agreement about the means of securing efficient and satisfactory delivery of health services. The HSE is the creation of the current Minister for Health, acting in the 2002-2007 government. While I was not privy to any discussions leading to its creation, I have found no evidence of any real attempt to secure any measure of cross-party consensus on the basic structure, which itself constituted a major innovation.
In a wide range of contacts with professionals involved in the delivery of health services (many of them employed in the system), with suppliers of services to the system and with people who rely on it to provide them with health services, I have found widespread doubt about the system's ability to deliver and innumerable examples of failure. As an observer with some experience in the design and delivery of public services, I have felt since the inception of the HSE that the structure is incapable of delivering to specification. That view is widely shared.
So far, I have found no evidence of any degree of consensus on a solution to the problem. This means that there is, as yet, no basis for the kind of cross-party consensus being called for. Those who believe that such a consensus is needed on this vital area of public service (among whom I include myself) should now set about convincing the Minister for Health and the Government in general to begin the process of building such a consensus.
Passionate expressions of commitment and sincerity by the Minister are not enough. Real, cards-on-the-table analysis and confrontation of ideas and approaches are what is needed. The prize is the health of the nation and is well worth the effort. - Yours, etc,
ALAN DUKES,
Tully West,
Kildare,
Co Kildare.
Madam, - Noel Whelan calls on the Opposition to support the Government in its long-running attempts to bring stability and confidence back to the health service.
He starts with extracts from the Tallaght speech made by Alan Dukes in 1987 and suggests Fine Gael should come to aid the Government again.
But it is illogical to draw parallels between then and now. Firstly, this Government has a clear working majority and doesn't need the votes of the opposition to implement policy. This is the most material difference to the situation which existed in 1987. The difficulty in Government now is not that it doesn't have the requisite votes, but rather that it doesn't have the appropriate policies.
Secondly, Fianna Fáil and the PDs have been in government for over 10 years and if the many issues surrounding healthcare have not been resolved in that period, it is appropriate that their inadequacies are highlighted. Why should the Opposition support the Government when they differ on items of policy?
The alarming thing which Noel Whelan's attitude demonstrates is that Fianna Fáil has come to believe it has an absolute right to be in power and that not only should certain journalists back the party to the hilt, but increasingly it believes even the Opposition should do so as well.
Noel Whelan goes on to reflect that Alan Dukes had the highest popularity ratings of party leaders in 1987, and attributes this to the Tallaght strategy. On mature reflection, perhaps he should attribute it to the unpopularity of Charles Haughey.
Will Noel Whelan suggest in time that there should be Opposition support for the Government's policies on incineration, taxation, electronic voting, transport (including Shannon Airport) - in fact, on any issue that might cause the Government embarrassment? - Yours, etc,
JACK O'BRIEN,
Ballycummin,
Patrickswell,
Co Limerick.