Six years to the day that you became Minister for Health, here is your report card Mary Harney
Mary Harney celebrates six years in charge of our health service tomorrow. That's a long time to be a minister -- she is in fact the second longest serving health minister we've ever had.
So what has he achieved? Six years is, after all, quite a pretty good stretch, wouldn't you think?
World War Two lasted six years and during that time the Allies managed to overcome the forces of darkness that threatened the future of the entire world.
Fixing the health service of a small country on the periphery of Europe is not quite the same gargantuan undertaking, but apparently it's going to take longer than it took to defeat Hitler and Hirohito.
Despite promises of improvements arriving somewhere down the line, our health service seems to be largely just as inefficient as it was in September 2004. Some might say it's even worse.
After more than half a decade in charge, the consensus must be that despite some pockets of success, Mary Harney's journey has ultimately ended in failure or, at the very best, a scraped pass mark.
It's getting almost boring at this stage to repeat it -- hundreds are awaiting admission on hospital trolleys each day. Outpatient waiting-lists stretch out for years in advance, in-patient lists are rising again. And we have had numerous safety scandals.
So how does the Harney record bear up to scrutiny? Let's have a look at her report card:
A&E: The minister's poorest subject. She promised early on to end trolley waits. You can massage the figures any way you want, but too many are still waiting too long and often in squalor for the care they need. Score: 1/10
Hospital Capacity: We were promised more beds but hundreds have been taken out of the system and there's no sign yet of a better community alternative. Score: 3/10
WAITING LISTS: 175,000 on outpatient lists, many waiting for years. In-patient lists on the rise despite the millions spent on the Treatment Purchase Fund. Score: 4/10
PRIVATE HOSPITAL CO-LOCATION: Mary Harney's love affair with private enterprise has come a cropper and not a single co-located bed has emerged. It would have been quicker to build extra public beds. Score: 3/10
REFORM: She oversaw cancer care reform, but that was really Tom Keane's baby. She introduced better regulation of doctors and other professions and helped reduce drug costs. There are concerns about closing down services in smaller hospitals although to be fair she's the first minister to grasp this hot potato. Score: 7/10
SAFETY: She has presided over a succession of hospital safety scandals. Each time she tells us that things will improve -- each time we wait for the next scandal to arrive. A recent survey showed four in 10 Irish people believe that the care they or their families received was below standard. Score: 3/10
ELDERLY CARE: Probably her best subject. The Fair Deal nursing home scheme was imaginative, although the plan to take medical cards off the elderly wasn't exactly a stroke of genius. Score: 8/10
EQUITY OF ACCESS: Has negotiating an expensive new contract for consultants improved equity of access for public patients? Not much evidence of this yet, although we live in hope. And while a prescription charge might sound good in theory, it's just another obstacle to accessing vital healthcare. Score: 4/10
THE HSE: It's easy to criticise the HSE, but there's a reason why it's so easy, and ultimately it's Mary Harney who is in charge of it. Score: 3/10
PRESENTATION AND COMMUNICATION: She's good at soundbites. But we have to ask ourselves, how much of this is just smoke and mirrors?
OVERALL SCORE: 43pc
Barely a pass and simply not good enough after six years.
And now that the money has run out, not much hope of an improvement next term.
Niall Hunter is editor of irishhealth.com