It has come to something when a former Taoiseach publicly derides the quality of our public services and administration, and directs such a frank and forthright attack at the current political establishment for its handling of the health sector.

And in his twilight time as Taoiseach, it seems that Bertie Ahern too is lamenting the opportunities he lost to effect radical reform across the public sector in exchange for the largesse lavished by the taxpayer throughout the last decade.

But now all is changed and changed utterly. Mr Ahern knows the forthcoming review of the public sector by the Organisation for Economic Co-operation and Development (OECD) will be hard-hitting in its analysis and, hopefully, radical in its recommendations. But he knows also that he won’t be around to see it through; that job will fall to his anointed successor and our new Taoiseach. The currents of the discussion about what is wrong with our public services and how they could be put right have been running for some time, but until now, few have been willing to identify a root cause of the malaise.

Undermining

Garret FitzGerald attributes it primarily to an undermining of the public interest through the erosion of tax revenues in ways he says did not occur in the early decades of independence, and more recently to the role of partnership in sustaining powerful societal interests.

The OECD will say in essence that a veritable quagmire of quangos is leaving the citizen vulnerable and short-changed.Looking back now at the original objectives and rhetoric of partnership, as enshrined in the 1987 Programme for National Recovery, the emphasis initially was on trading moderate increases in basic pay for significant cuts in personal taxation, and making the quantity of resources available for public services contingent on economic performance.

However, the quality of service that ought to be expected was never at the core of the debate. In fact, it became entirely incidental to it.

Enduring mindset

Unfortunately, the lingering problem is that an enduring mindset, which held that tax cuts were vital for firing economic growth following a decade in the doldrums, has now become so deeply ingrained on the psyche of the voters, that they either can’t see, or refuse to accept, the potential of personal taxation and public management for improving quality of life for all.

The primary consequence is that people now appear content to buy the services they could need as individuals, rather than to support a tax base that would provide the necessary resources for a bigger public infrastructure that benefits everyone. An unexpected side-effect of partnership has been the slow advance of risk aversion right across the health sector. Rather than planning decades ahead, it often reflects an increasingly conservative societal consensus, which gives greater priority to small steps over bold strokes that would not only shatter the cosy consensus, but actually prove that innovative health management is achievable with a tax base that balances the requirement for competitiveness with public and citizen needs.

If Dr FitzGerald’s criticisms are valid, then the real question is not why there has been a failure to dispense with so many ‘superfluous administrators’ up to now, but why more of them have not been utilised more effectively in the first place. If the HSE was to implement a typical private sector-type redundancy programme, the total number of retirements would be anywhere between 5,500 and 11,500, and the cost anywhere from €400 million to €850 million.

Expectations are now rising in the HSE that a significant package is about to be offered to everyone under 30 and over 50, starting with the management, administration and ICT grades.

Significant thinning

Some expect the number of local health managers will be reduced by half, and a significant thinning of the number of assistant national directors, now thought to number around 122. It’s also expected that bonuses will, from this year on, be awarded to maybe one in four managers rather than one for all.

The HSE will remain as the lightning rod for a deeper popular anger with our public services for some time. Why? Because while common sense tells people they can’t have it every way, their politicians condition them every day into believing they can. That said, there are only so many more strikes the HSE can take before its protections are spent.

Rebalancing

Mr Cowen’s steady-as-she-goes record tells us that he will not try to reforge the public interest by returning to high levels of personal taxation. But his rhetoric of patriotism, of encouraging all public officials to combine wit and wherewithal in order to deconstruct and reconstruct public services for a higher goal underlines a coming rebalancing of the social partnership project, which looks increasingly frail and threadbare, and singularly ill-equipped, as it stands, to cope with urgent needs.