It’s open season for Stephen Donnelly – but a decent healthcare system is key to a united Ireland

The minister dismissed the quotes as coming from “anonymous sources”. Not so anonymous and easily dismissed was HSE chief Paul Reid, who told Hugh O’Connell and Jack Horgan-Jones: pandemonium that Donnelly’s attitude “angered” HSE staff, who felt he could be disrespectful. This second book offers a similar picture to the first as it states that Holohan did not trust Donnelly with the advice he was giving and that the minister enraged staff in his department by coming to the office despite showing Covid-19 symptoms . Donnelly has again denied allegations against him, but there is a clear pattern of health system officials actively reporting against their minister. The behavior would not be tolerated by a more experienced politician.

The Health Secretary was also ambushed by Fine Gael ministers in Cabinet last week over the structures surrounding ownership of the new National Maternity Hospital. Fine Gael’s Heather Humphreys, Helen McEntee and Hildegarde Naughton complained that the project’s approval was rushed and called for guarantees that all legal healthcare services would be available at the new hospital.

The same Fine Gael ministers had little enough to say when their own former Health Secretary, Simon Harris, signed an agreement for the hospital that had weaker terms than the current agreement. And those same ministers were pretty quiet two weeks ago when a candidate for the Fine Gael general election resigned from the party, accusing her of “bullying, character assassination, intimidation and defamation”.

Fianna Fáil Senator Lisa Chambers hit back, saying Donnelly was being undermined. It was about time the health secretary got some measure of support from his electoral party. He’s far from loved in Fianna Fáil, believing he’s just flown into the party and got a seat in the cabinet. But the health secretary must take responsibility for failing to secure upfront support for the cabinet.

The narrative of possible Catholic Church interference in the hospital is now threatening the entire project and the minister present seems at a loss as to how to deal with it. Building a €1 billion facility on one of the country’s largest hospital campuses, on land in an area with the country’s most expensive real estate, is no easy feat, so skillful handling is required.

Donnelly is the latest in a long line of ministers to find the opposition’s outlandish rhetoric a world away from the government’s painful reality. But attacks on his authority from all sides are fueling speculation that he will be out of office after the cabinet reshuffle in December this year. Having held the job during the pandemic, when the scope and spending of healthcare services has increased at unimaginable rates, Donnelly has little time to show he has the handle on the long-term reforms needed.

The sense that self-interest will stall and delay any reforms until the incumbent minister moves on is palpable. New year, new minister, new priorities – same old story. The lack of stability in the Ministry of Health has existed for a decade.

Mary Harney was the last minister not to have a “temporary” enrollment in her office, allowing her to advance initiatives such as the National Cancer Strategy.

The tenures of James Reilly, Leo Varadkar and Simon Harris were speckled with some noble measures, particularly in primary care, but were mostly forgotten. Donnelly risks falling into the same category when it comes to leaving no trace.

A post-pandemic update of the Sláintecare plan that also allows for a touch of practicality would be helpful. Again, this is anything but as easy as it sounds. The end of the two-part health care system seems to be a claim of all political parties. How to get there is the hard part. Reducing waiting lists, which were at record highs before the pandemic and worsened by the crisis, is an immediate priority.

The outcome of the General Election in Northern Ireland gives increasing importance to creating a fit for purpose healthcare system. The election result leaves two out of five voters in the nationalist camp, another two out of five in the union tent, and a now growing out of five voters with no footing in either. Tribal loyalty does not determine their votes. Achieving a policy change does.

Bread and butter issues shaped this election. The cost of living was more pressing than a border survey and hospital waiting lists led the Irish Sea border for relevance. The NHS used to be the biggest ally for those who wanted to keep Northern Ireland in the UK. But the shocking decline of Britain’s healthcare system after 15 years of Tory underinvestment has tarnished its standing.

United Ireland isn’t just about employee demographics. It shows the people of Northern Ireland the benefits of union with the Republic – economically, politically and culturally. In terms of job opportunities, infrastructure and social advancement, the South has in many ways overtaken the North in the last generation. Providing improved public services remains a goal.

Having a healthcare system that ranks among the best in Europe would help win over the non-aligned, persuade doubting nationalists and give some reassurance to unionists that life would be better in a united Ireland.