We need to know more about Leo (and where he stands on health policy matters)

Posted in Articles by saraburke on July 24, 2014

As Dr Leo Varadkar takes the helm, little is known about where he stands on health issues, see below for column from Medical Independent on 24 July 2014. 

So Leo Varadkar is the new Minister for Health. Yet, for someone who is known for calling it as it is, we know remarkably little about where Dr Varadkar stands on key public health and health service issues.

We know he is a doctor as well as a young, ambitious politician. The son of an Irish mother and an Indian father who worked as a GP in Blanchardstown, Leo followed his father’s career path, training for medicine in Trinity College Dublin. After the usual postgraduate stints in hospitals, Leo also opted to be a GP in the community he lives in and now represents.

But the lure of political life must have been strong for Leo. He was co-opted onto Fingal County Council in 2003 and first elected in 2004, aged 24. By 2007, he had clinched a seat in Dáil Éireann and was the party’s spokesman on Enterprise Trade and Employment. In May 2010, he was one of the group who led a heave against their leader, Enda Kenny. Despite that, he was reappointed to the front bench as spokesperson on Communications and Natural Resources.

In 2011, Leo was re-elected with nearly 20 per cent of his constituency vote and appointed Minister for Transport, Tourism and Sport. Although the post was not a natural fit for Leo, he is regarded to have done well in the position, quickly getting on top of his brief, willing to take advice in areas he knew little about and critically, ensuring the ‘Gathering’ was a success story for Irish tourism.

But none of that throws any light on where he stands on health matters, apart from opposing the introduction of alcohol sponsorship from sports organisations as sports minister on the basis that there was “no evidence to show that a ban on sponsorship would be effective in terms of reducing alcohol consumption amongst youths”.

Previously on a Vincent Browne show before the 2011 general election, where the book The Spirit Level by Richard Wilkinson and Kate Pickett was discussed, Varadkar was on the panel and dismissed the links between income inequality and health outcomes.

Speaking on the plinth of Leinster House after his appointment, Leo took a much less controversial line. He said: “Health is the kind of department that affects almost everyone at some point in their life and I think there is an opportunity there to really improve things and to make a difference in people’s lives and make them better…” No one could disagree with that.

He went on to say he was going to meet the relevant officials, get to know the HSE and formulate a plan with a view to hitting the ground running in September. He stated that he could not solve “all the problems in health in the next 18 months”. All perfectly sensible.

Specifically, he mentioned “getting the budget back in order, extending primary care to most or all the population… reducing the cost of health insurance and cost of medicines, dealing a lot with A&Es”.

Each of these were top of the previous Minister’s priorities, ones where he failed to deliver. So can Varadkar succeed where Reilly failed? One has to hope so and give him some leeway to find his way into the health ministry.

“Getting the budget back in order” will require garnering political support from cabinet and, crucially, from the Economic Monetary Council, where all key budget decisions are made. Leo has to secure a sufficient budget for 2015 and 2016 so that no supplementary budgets are required in the run up to the next election. This is no easy task, given the amount taken out of the health budget since 2009.

“Extending primary care to most or all of the population” shows he is in line with this Government policy that so far little progress has been made on. However, he refers to ‘primary’ care, not free GP care. Extending free primary care (ie, access to PHNS, physiotherapy, etc) would cost considerably more than free GP care. Government has now committed to introduce free GP care to under six-year-olds this year and to “prioritise the over ’70s in the next phase of the roll-out of free access to GP care, with the subsequent extension of free GP care to the six-11 year-old and then 12-17 year-old cohorts”.

Remarkably, this is the only specific health commitment in theGovernment Statement of Priorities published on the day of the reshuffle. Reducing the cost of health insurance and medicines as well as fixing the crisis in emergency departments are all hornets’ nests nationally and internationally.

That said, picking five rather than a myriad of priorities, when nothing actually gets done, seems like a prudent start. Interestingly, there was no mention of medical cards in Varadkar’s first doorstep interview on health. Doing no further damage on that front is central to his integrity as Minister for Health.

Not known for his radicalism on social matters, it will be really interesting to see how Varadkar fares in health.

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