A laboriously constructed working majority is a huge prize that means our new Government has the potential to stay the course and implement its programme.
For Stephen Donnelly, the new Minister for Health, this gives him a set of opportunities that none of his three most recent predecessors has had. So far, so good.
Unfortunately, he also comes into office in the midst of a live global pandemic that the WHO has announced this week is now actually accelerating, but with a national mood that appears increasingly to think that we are out the gap, which we almost certainly are not.
The first 100 days
Donnelly’s first 100 days are his only real opportunity to define and set the tone for his term of office. He will need to bring his best game, leveraging nine years as a TD, 27 months as Opposition health spokesperson, and his professional background as a management consultant.
He undoubtedly understands the hand he has been dealt. He has no ministerial experience to either draw upon or be tainted by; unlike James Reilly or Leo Varadkar, he is fortunate to be in the same party as the Minister for Public Expenditure and Reform.
The furore over who did and didn’t get the cabinet nod in Fianna Fáil, while uncomfortable to live through, also means that his leader Micheál Martin is now even more invested in his success than he otherwise would have been. Health, housing, and homelessness were the defining issues in the last election and are likely to be the ones by which this coalition is judged.
While his hand is not a bad one, he has to learn fast how to walk the perilous path from Opposition spokesman to minister.
Health is by far the toughest gig in Irish politics, but it is no graveyard. After all Charles Haughey, Brian Cowen, Leo Varadkar, and now Micheál Martin all held the position before ascending to the top job, and both Michael Noonan and Brendan Howlin went on to lead their parties and play key roles in government.
Minister Donnelly needs to quickly articulate and communicate his plan for the next six months, for 2021, and for the full five years of the government’s term. And while the clock is already ticking, it’s also critically important that he allows himself the time and space to absorb his brief and get the measure of those he now leads in the Department of Health and the HSE.
Present and future crises
Donnelly has to pick up the baton on the health response to Covid-19 and ensure clarity of position and consistency of messaging to the public. He needs to establish his voice as our political guide on what we need to do to maintain optimum safety in an ongoing pandemic.
Essential and business-related travel, holiday travel, mask wearing, social distancing are all issues on which he needs to provide consistency and clarity. Without that, the discipline of recent months will quickly be lost for good. He also needs to be on guard for any resurgence of infection rates.
Winter, too, will soon be upon us. It’s never pretty in the health service, but combined with the necessary precautions for Covid-19 and the ongoing threat of either seasonal flu or a second wave of Covid infection, this year it could even be ugly.
Donnelly has already spoken of the significant negative impact that this will have on capacity in the system, a capacity that has never been adequate for the winter challenge or waiting lists. This kind of overcrowding now represents a clear and present danger that must be avoided at all costs.
Donnelly needs to move quickly to plan and implement additional capacity to avoid overcrowded emergency departments. That requires solutions way beyond the public hospital system; he must harness primary and social care, public and private nursing home capacity, and especially public and private homecare.
From vision to reality
Armed with voluminous briefing packs, the Minister must distill his pitch for the 2021 estimates process. What can he meaningfully do in 2021 that supports both the Covid emergency and his longer-term reform agenda?
The estimates process is complicated beyond measure by the new economic uncertainties. He will need to find his ground and work the system of government to make progress. How he fares in this first estimates round will be an early marker of his positioning and the commitment of government to help him succeed.
Of all the health spokespeople, Stephen Donnelly was the only one who dared to acknowledge that Sláintecare is not a plan. It is a document high on vision and aspiration but short on sequencing, prioritisation, and funding.
Other parties chose to use it as an electoral flag of convenience, as a slogan if you will. Vision is important and needed. However, while it is necessary, it is hardly sufficient. Donnelly must figure the who, what, where, when, and how of bringing it to life. No small task, but it is one (of many) that will determine whether or not he goes on to become a great Minister for Health.
A discussion on the future of Irish healthcare
This week, 360 MD Dan Pender sat down with Tony O’Brien, former director general of the HSE (2012-2018), 360 strategic advisor, and columnist, to discuss the next five years in healthcare, what’s in store for the new Minister for Health, and leadership in the Department of Health. Click or tap the play button above to start watching.
Discussion highlights include:
- Minister for Health Stephen Donnelly’s next steps.
- What Minister Donnelly should hope to achieve in his first 100 days.
- Private hospitals in a Sláintecare future.
- How to resonate with decision-makers in the HSE and Department of Health.
- The health system and the government’s response to Covid-19.
- New opportunities for e-health and telemedicine.
- Will “Covid-speed” decision-making continue?
- Ireland’s health service in 2025.
About the author
Tony is a strategic advisor to 360 and veteran of Irish and international healthcare and one of the country’s most prominent organisational leaders. From 2012 to 2018, he served as director general of the HSE, Ireland’s national health service. Tony is also an associate and council member of the Irish Management Institute; a chartered director; and a columnist for the Business Post.
