Micheál Martin is spending money at the moment on the health services at a remarkable rate.
In recent days, he has announced a dazzling array of new units, including radiation oncology units in Cork and Galway, and A&E units in Naas and Roscommon. Indeed, such is the largesse that he is distributing - some €85 million - that his colleague, Mary Hanafin, was moved to remark that he must think he is going somewhere in the next Cabinet reshuffle.
No doubt she regrets ever opening her mouth, but her comments reflect a general cynicism regarding allocation of resources for health.
For too long they have been seen as being driven either by political expediency, or by responding to the lobby groups which shout the loudest.
No one could query the value of the initiatives announced this week, but the fact is that there is little or no transparency about why this money is being spent now, much less the values which have driven the decisions.
The health services are insatiable. No matter how much money is spent on them, more could be spent. Innovative technological advances can cost thousands per treatment.
Every country in the world rations healthcare, but where should boundaries be drawn?
Intellectually, we all recognise the reality of limited resources, but when it comes to decisions that affect us or our loved ones, we tend to lose all perspective.
There is also a bias towards funding acute hospital-based services, yet the fact is that without an adequate emphasis on building health we will always be stuck with fighting preventable disease.
The Government is committed to primary care, to an integrated service encompassing everything from GP care, to physiotherapists, occupational therapists, nurses, home helps and social workers.
Yet the level of funding needed for primary care has yet to materialise.
Well-developed primary care services would take a great deal of the burden off hospitals. For example, physiotherapists can help older people to be mobile longer, and to recover more quickly after hip replacements, thus freeing up hospital beds.
Minor surgery could be performed by GPs. A&E departments are under pressure because GP care is effectively only available in office hours.
Yet when people think of health services, they think firstly, and sometimes only, of hospitals. Many of us only engage with the question of the allocation of resources when we fear that we, or those we love, are in danger of not receiving adequate treatment. Yet there are broader issues than our own or our family's needs.
Prof Clarke Cochran, an American political scientist, is one person who has grappled with the question of what values should guide the allocation of health resources. He is in Dublin next week to address a conference on equity in healthcare. Brave man that he is, he suggests that Catholic social teaching has something to contribute to the debate. In Ireland, even more than in the US, hackles are likely to be raised at that suggestion.
Sadly, people are much more familiar with the negative norms in Catholicism against abortion, euthanasia and stem cell research than they are with the positive norms in Catholic social teaching.
For example, it is a key part of Catholic teaching that resources should be allocated according to the needs of the individual, rather than on any ability to pay. Similarly, there should be an emphasis on treating with particular care those who are most vulnerable or poor. The dignity of the human person must be respected at all times.
Religious orders established their hospitals in Ireland for the most part to meet the needs of the poor.
Those religious orders have been doing a lot of heart-searching in recent times as to how well the most vulnerable are being served.
For example, it is deeply ironic that an elderly patient can spend three days on a trolley in a hospital founded to meet the needs of the most needy in a dignified way.
Some religious orders are questioning whether they are providing any kind of distinctive service any longer given the degree of State funding and control, which can determine everything from staffing to the number of treatments given.
Prof Cochran suggests these are important questions which must be faced, along with the question of how successful church institutions have been in living up to their own norms.
Where is Catholic social teaching in operation, as opposed to remaining a theory? How well have lay people who work in these hospitals been educated about Catholic social teaching, and how many have "bought into" the vision of radical equality which underpins it?
He is not suggesting that Catholic social teaching should be accorded some kind of privileged position in any debate, but merely that it provides a kind of intellectual tool kit to wrestle with these kinds of questions.
However, the idea of debate presupposes some kind of forum where these questions can be discussed.
Politicians will continue to give polite hearing to the need for equality, as they did recently at Inchydoney, while privately dismissing it as naïve unless they perceive a mandate for change from the public.
Community groups have an important role in any discussion, but there is also a need for debate at a national level. Given that it is such an important subject, I believe that it merits a mechanism like the public hearings held by the All-Party Oireachtas Committee on Abortion. Any group or individual who wished to be heard tendered a written submission, and could then be called before the committee.
A calm and restrained atmosphere meant that for once more light than heat was generated.
The debate on healthcare has been dominated by medical professionals and economic considerations rather than really looking at underlying values. The public and other stake-holders should be given an opportunity to present their point of view, and holding public hearings could spark a long overdue discussion as to what kind of health services we really want.
Prof Cochran is giving a free public lecture at 7.30p.m. on Wednesday, September 22nd, in King's Inns, Dublin. He is the keynote speaker at a conference on "Equity, Health and Healthcare" on Thursday 23rd, also at King's Inns. For more information telephone 01-6677349.
bobrien@irish-times.ie