On Thursday, in the prime slot on Morning Ireland, Neale Richmond drove the first big tank on to the succession lawn. He started the logroll of Fine Gael TDs endorsing Simon Harris as the man to lead party and country. This was the key moment in the making of a taoiseach.
I listened back to the interview wondering whether I had missed something – but I hadn’t. What I thought I must have missed was “Simon was a great minister for health”. Harris, after all, held that critical office for four years. If he’s leadership material, that’s the crucible in which we must have seen greatness emerge.
The only thing Richmond could think of saying about it was that Harris was a brick during Covid. In fact, Harris was marginalised during that crisis: the State’s response was run from the Taoiseach’s office. What Richmond could not say was that our next taoiseach left his mark on the health system as a whole.
Harris will be the fourth of the five taoisigh who have come to the office for the first time this century to have served previously as minister for health. This suggests – does it not? – that however else you get to the top in Irish politics it is not by fixing things.
By my rough reckoning, Brian Cowen (elected taoiseach in 2008), Leo Varadkar (2017), Micheál Martin (2020) and Harris (presumably 2024), had served a total of 11½ years in the Department of Health before ascending into the firmament and becoming A-number-one, king of the hill, top of the heap. Which means that the health system has enjoyed the stellar leadership of the brightest and the best, the most talented and effective members of the political class.
Or perhaps it simply means that we have a political culture in which you don’t get to be head honcho by making broken systems work. You survive their dysfunction. The Abbé Sieyès, a big figure in the turbulent years of late 18th- and early 19th-century French politics, when asked what he had done in the French Revolution, replied: “J’ai vécu” – I survived. Harris now joins the Health survivors’ group that consists of every first-time 21st-century taoiseach except Enda Kenny.
As minister, Harris appointed two very capable people to drive long-term reform of the health system. Both ended up resigning in frustration
The health system is Ireland’s most chronic institutional mess. It is an incoherent amalgam of competing forces, part private business, part religious charity, part national service, part insurance scheme. It is a chimerical creature with the head of a capitalist, the body of a socialist, the feet of a missionary and the tail of a professional interest group.
Hence the paradox of Irish politics. Ambitious politicians usually want to get their hands on big-spending departments and health is the drunken sailor of the spendthrift world. It takes well over a fifth of all allocated government expenditure. And by definition it has a vast impact on the lives of citizens from the cradle to the grave.
Yet those ambitious politicians don’t crave the opportunity to control it – they dread it. Cowen compared the Department of Health under his stewardship to “Angola” because it was full of landmines. Martin joked that this description was too sunny: “Angola is honeymoon country.” It’s a ring of fire the rising minister has to pass through. The primary object is not to put out the fire – it is to avoid getting too badly burned.
It goes without saying that, with so much money to spend, a minister for health will probably do some good things. But which of these future taoisigh left a profound mark on the system itself? Which of them took on the big job of ending the gross inefficiencies and glaring inequities inherent in the way it is set up? None of them. They survived. While the landmines went off, they were nimble enough to duck and move on.
Answer this quiz question: which minister for health who went on to become taoiseach created the Sláintecare strategy that governs the medium- and long-term development of Ireland’s healthcare system? It’s a trick question because none of them did. That job was handed over to an Oireachtas Committee on the Future of Healthcare, headed by Róisín Shortall.
We have a political system in which the Oireachtas exists to rubber-stamp government decisions. But in this one case, successive governments were all too happy to hand the task over to parliament and, in effect, to a member of a very small Opposition party. Why? Because none of the ministers wanted to do it.
As minister, Harris appointed two very capable people to drive long-term reform of the health system. Both ended up resigning in frustration. Laura Magahy, head of the Sláintecare implementation office, quit in 2021, after Harris had left the department, citing “slow progress” in “key areas requiring dedicated, focused, reform effort”. She was followed by Professor Tom Keane, head of the Sláintecare advisory group, and the man who had earlier transformed Ireland’s cancer services. He had “come to conclude that the requirements for implementing this unprecedented programme for change are seriously lacking”.
Those requirements include political leadership. Harris pledged to introduce free GP care for children under eight by the middle of 2020. It arrived three years later. He was going to have the under-10s covered by the middle of 2021 and the under-12s by the summer of 2022. Neither happened. He also said the children’s hospital “will be finished in 2022 and open in 2023″. Neither of those things happened either.
What all of this tells us is that actual achievement in government is not what gets you to the top. Simon Harris is not becoming our leader because he has proven he can solve chronic problems. He has risen without trace, which is the perfect path to power in contemporary Irish politics.
It’s not the survival of the fittest. It’s the survival of the smoothest. Building a positive media profile and performing well in broadcast interviews are the tests you must pass. Stay out of trouble and you too could be taoiseach.