In response to allegations made against then Taoiseach Leo Varadkar which appeared in Village Magazine, in March 2022 I submitted a formal statement to the Garda investigative team regarding the Official Secrets Act (hencefore OSA); in particular pertaining to the responsibilities of Martin Fraser, then the most senior civil servant in the country.
I also pointed to an usually-timed departure from precedent in Fraser’s appointment as the next ambassador to London, which is in the gift of Fine Gael’s Simon Coveney as Minister for Foreign Affairs.
Certain circumstantial evidence remains pertinent to any interrogation by the Oireachtas into what has occurred, namely:
February 11, 2019: the NAGP union write a threatening letter to Fine Gael HQ warning it would be canvassing against them in upcoming local elections and the forthcoming general election.
April 10, 2019: the confidential GP contract is couriered from the Taoiseach’s Department to then Taoiseach Leo Varadkar at Baldonnel airport without formal authorisation and with no conditions attached.
April 25, 2019: an official in that Department of Health warns that ‘Unilateral publication of the Agreement, in the absence of confirmation from the IMO that it is satisfied with the final text, would represent a serious breach of trust.’
We still do not know which civil servant authorised that initial leak.
It beggars belief that in the seven months from the time that the revelations appeared in Village Magazine (October 2020), and the case being raised to a criminal investigation (April 2021), that the most senior civil servant in the country – with responsibilities deriving from the OSA including internal breaches – does not appear to have conducted an internal inquiry.
Bear in mind that if a junior official leaks a confidential file it is usually career suicide, and potentially results in criminal charges.
I therefore previously argued that it is reasonable to assume that no junior official leaked the document, and that authorisation came from Fraser himself.
It is important to emphasise that Martin Fraser was one of three Civil Service Commissioners with certain legal powers vested in him that exceed even the Taoiseach of the day.
The logic underpinning such formidable powers is that they are responsible for the preservation of the institutions, statute and assets of the State beyond the life of any government. Hence the concept of a ‘permanent’ government and its daunting power.
With such power arrives commensurate responsibility. It became apparent in my dialogue with members of the Garda investigative team that Martin Fraser had not conducted an internal probe, and his role was never under investigation.
On legal advice I withdrew my statement and was advised that the matter would return to the Oireachtas for clarification and investigation.
The Duties of the Oireachtas
Now that the DPP has ruled that Leo Varadkar has no case to answer the matter comes back to the Oireachtas, which ought to clarify the following points before Martin Fraser departs for London. He should be compelled to explain:
Why he failed to conduct an internal investigation into the leaked and confidential contract, either in the seven months before the Gardai gave it criminal status or since.
If Martin Fraser was indeed responsible for the release of the document, why he didn’t, as cabinet secretary, inform the cabinet. Further to this, it should be asked how and when the cabinet first learned that the contract had been leaked, and was this only through the Village Magazine article.
How it is that a Garda investigation spanning eighteen months seemingly never examined the role of Martin Fraser given the strong likelihood the document was released from his Department.
This affair has set a very damaging precedent whereby the habitual violation of the OSA becomes a risk to the security of the State in the event of future leaks. The DPP decision that Leo Varadkar has no case to answer suggests that sensitive documents may now be casually disseminated.
The Oireachtas needs to determine, once and for all, on whose authority the contract moved from the Department of Health to the Taoiseach’s Department.
Mr Fraser should be directly questioned as to whether he authorised that step, using his higher powers as head of the civil service, and commissioner, to demand the release of the document from the then Secretary General of the Department of Health, Jim Breslin to his own Department of the Taoiseach. Mr Breslin would have been obliged to release the document to his superior in the civil service chain-of-command.
Moreover, the DPP’s decision makes it imperative for the Oireachtas to clarify who is responsible for a breach of the OSA.
Leo may be off the hook, but important issues surrounding the affair remain opaque. The fundamental matter to be addressed is who precisely within the civil service authorised the initial leak of the document to Leo Varadkar.
It is quite simply bizarre that Martin Fraser – without previous diplomatic experience in the Department of Foreign Affairs – was appointed ambassador to our most sensitive and prestigious embassy at a time when a criminal probe into a leaked document remained unconcluded; in a matter over which he held overarching responsibility.
Bernadette Gorman was a civil servant for twenty years and held statutory powers. She worked as an Inspector and a trainer of Inspectors.
Feature Image: (c) Daniele Idini.
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The ongoing criminal investigation into an alleged breach by Tánaiste Leo Varadkar – while Taoiseach in 2019 – ofcorruption legislation and the Official Secrets Act (OSA) should be broadened to include members of the permanent Government; especially the Secretary General to the Department of the Taoiseach, Martin Fraser. Instead, he is set to be become Ireland’s next ambassador to the U.K., despite having no diplomatic experience.
Serious charges of corruption were first levelled against Varadkar in Village Magazinein October, 2020, but this article primarily focuses on the importance of the OSA investigation pertaining to the responsibilities of top civil servants. The OSA requires the relevant civil servants to perform a formal authorisation process before the release of a confidential official document.
The weight of responsibility for upholding the State, its assets, institutions, and statutes in perpetuity falls to civil servant members of the permanent government. The formidable powers vested in senior civil servants are commensurate with their responsibilities.
Chain of Movement
We know that a confidential draft G.P. contract was acquired by Leo Varadkar through his own Department of the Taoiseach, which received it from the Department of Health, and that, bizarrely, this was couriered from the Taoiseach’s Department to Baldonnel Aerodrome to the then Taoiseach.
It is safe to assume that that this unorthodox chain of movement involved the State’s most senior civil servant, Martin Fraser, and perhaps then Secretary General of the Department of Health Jim Breslin.
Notably, an official in the Department of Health warned that ‘Unilateral publication of the Agreement, in the absence of confirmation from the IMO that it is satisfied with the final text, would represent a serious breach of trust.’ The leaking by Varadkar of the document to his friend Dr Maitiu O Tuathail, the President of the rival National Association of General Practitioner (NAGP) surely “represented a serious breach of trust.”
Moreover, according to the FOI received by Sinn Féin TD Pearse Doherty even ‘the line Minister responsible for the negotiations [then Minister for Health Simon Harris] was unable to obtain the contract from his officials.’
If the draft contract had been acquired by Leo Varadkar from a more junior official it would not be the subject of a criminal probe, as there would have surely first been an internal inquiry under the Secretary to the Government, Martin Fraser.
We can therefore take it for granted that the release of the document to Leo Varadkar was authorised by the State’s most senior civil servant: Martin Fraser. If so, it begs the question why Fraser would have permitted this to happen.
Legal Obligations
What then were Martin Fraser’s legal and constitutional obligations?
First, as the State’s most senior civil servant he should have satisfied himself and informed the Cabinett under 2018 anti-corruption legislation and the OSA, that Varadkar was not acquiring a highly sensitive document for corrupt and unlawful purposes. An apparent failure by Fraser– who originally joined the Department of the Taoiseach as finance officer in 1999 under Bertie Ahern – to interrogate why Varadkar sought a hard copy to be delivered to him at Baldonnel displayed an unacceptably permissive approach, at the very least.
Secondly, Fraser had an obligation as Cabinet Secretary to inform the Cabinet that Varadkar had acquired the confidential G.P. contract under the OSA. Any decision to release such a sensitive document should have followed normal Cabinet procedures, or at least the advice of the Attorney General should have been sought.
That the roles of Fraser, and, to a lesser extent, Breslin do not form part of the Garda investigation sets a dangerous precedent, with the potential to destabilise the legislative basis of the State itself. The powers of the civil service operate in perpetuity via a constellation of interacting legislation, of which the Ministers and Secretaries Act, the OSA and civil servants’ contracts are integral parts.
Many now consider the leaking of the G.P. contract to have been relatively harmless, and question whether Leo Varadkar had anything to gain from it. But that the Gardai have given it the status of a criminal investigation demonstrates the gravity of the matter. Any breach of the OSA casts doubt over the integrity of senior officials – especially Martin Fraser – and by extension state institutions.
These processes are not now being interrogated in what appears an alarmingly narrowly focused investigation.
Despite repeated attempts to bring this matter to the attention of senior members of the Gardaí, I have received no response to date.
Ambassador Role
If he was under investigation, Fraser would surely not be departing for the role of Ambassador to the U.K..
That he was proposed in July 2021 for the London posting, while the investigation was underway – and where it had been raised to criminal status encompassing the OSA since April 2021 – gives rise to serious concern.
That appointment process calls into question the judgement of the current Taoiseach, Micheál Martin the Tánaiste, Leo Varadkar and the Minister for Foreign Affairs, Simon Coveney. Formal democratic decision making is being sidestepped, amidst the horse-trading of a tripartite coalition that devolves to the permanent, unelected government. The botched secondment of Tony Holohan – in which Martin Fraser is also implicated – confirms this impression.
As in Holohan’s case, with Fraser’s appointment to London, executive decisions appear to have been made in violation of normal procedures. Indeed, Fraser has no prior experience as a diplomat with the Department of Foreign Affairs.
From what we know of what is in the public domain, Fraser was among a suite of names proposed for various overseas positions, which were brought to the Cabinet for consideration on July 27, 2021, just as the controversial proposal to appoint Katherine Zappone as UN special envoy was unravelling.
The Irish Times carried a story that afternoon stating that Fraser had been “proposed” that day for the London Embassy job, but it remains unclear when the Cabinet actually signed off on this appointment.
The Irish public now have a right to know whether Fraser knew the purpose for which Varadkar was obtaining the sensitive contract in an unorthodox fashion; and if not, why didn’t he attempt to ascertain this.
The role of Martin Fraser – along with the then Secretary General of the Department of Health Jim Breslin who should have received any such instructions in writing – should form part of this criminal investigation.
In the controversy surrounding the leaking of a confidential document by then Taoiseach Leo Varadkar last year, a key point has been missed regarding whistleblower Chay Bowes’s motivations. As an insider and former head of the VHI Homecare division Bowes gained significant insights into the operation of the Irish health system, especially the HSE. This interview probes into the obstacles he faced in attempting to deliver an effective model of community care away from overcrowded hospitals. He argues the HSE perpetuates dysfunction to the benefit of the private system.
Chay Bowes first interfaced with medicine through the Irish Army Medical Corps in 1988. This stoked a passion for healthcare which led him to take up a job as a phlebotomist, where he encountered an older generation of hospitals, such as St James’s, where he worked with elderly patients in the country’s public health system.
This experience coloured his view of the health system as it evolved to become, as he puts it, ‘more focused on financial outcome rather than patient outcome,’ and led him to set up his own company, focused on clinical work in people’s homes.
He had found that general hospitals tended to be ‘Victorian constructs, where we put all the sick people who are susceptible to infections, so that they can mix with other sick people.’ He concluded ‘that much of what happens in the hospitals doesn’t really need to happen there, and a huge volume of those patients could be treated at home in a cheaper and safer holistic fashion.’
After the dismantling of small, community hospitals Bowes observed ‘pressure building on the larger general hospitals to become the catchall for all kinds of diseases and complexities,’ and that this ‘contributed to the ongoing perpetual dysfunction which is today what we call the HSE.’
Taking out a bank loan, he purchased a van to move around the nursing homes, taking blood samples. By that stage he had observed thousands of elderly arriving into hospital in taxis and ambulances for routine blood samples. There they were catching flus and colds, so he said to himself: “why don’t I develop a system to treat those people out in the community?” This was back in 2004-2005, but he was told that’s not how things are done.
Undeterred, he decided to take an extended leave of absence from the hospital to set up a service doing these blood tests in the community, which proved very successful. The only limitation was that he was working alone.
At that point, he expanded his service to give vaccinations in the community too and took on a few employees. The first company evolved into another, leading to a contract with the HSE in 2007 worth €14 million. That business was focused on patients with chronic obstructive pulmonary disease and chest diseases. Its rationale was to keep various types of patients in the community, who were repeatedly being admitted to hospital with lung diseases.
‘So, they didn’t go into a hospital, where people tend to get sicker, particularly those with lung diseases. It also helped these patients,’ he says, ‘that their social networks were intact.’ Soon there were two hundred working for the company.
Resuscitation room bed after a trauma intervention.
Tara Healthcare
At that point he brought Dr. Gerry McElvaney on board, ‘a really patient focused guy,’ he says, ‘who was highly intelligent and super-committed to doing things differently.’
Together, they pushed forward with what became Tara Healthcare. When patients were surveyed, he says, ‘ninety-eight percent preferred to remain in the community under our scheme rather than go into hospital: all the data was saying that this was a much safer.’ It was also cheaper to deliver, and the patients’ families were delighted to remain with their loved ones.’
He argues that they had created a perfect example of how a community-based scheme could be delivered cheaper with better patient outcomes, and where staff were really happy too, as they could get out of the acute hospitals.
However, he encountered, ‘an incredible level of scepticism around innovation in Irish healthcare.’ In one case, he says, there was a hospital in Dublin, which ‘wouldn’t send patients to this new service, because they didn’t like our medical director because he came from another hospital group. Professional rivalry is rife in Irish Medicine, sometimes to the detriment of patients.’
HSE Logic
Time and again he was met with the perverse HSE logic of ‘it’s doing really well, so let’s shut it down and send all these patients back into the hospital.’
The HSE’s reaction to the Financial Crisis of 2008 was just like its dysfunctional approach to COVID-19 he argues. They closed his operation down because hospitals ‘which were in perpetual crisis wanted us to move this service into their area.’ A senior HSE figure told him directly that ‘“what you’ve done in Dublin is almost too good. Everyone’s going to want it. They’re going to want it in Galway. They’re going to want it in Limerick” So, they wouldn’t fund it because they were already funding the dysfunction.’
The agency funds the dysfunction to a certain level of service with tens of billions of euros. And when something outside of the system comes along and demonstrates efficacy, financial viability, and good patient outcomes, that’s irrelevant because they still have to fund the dysfunction. It’s like trying to repair an airliner in mid-air – you don’t want to land because it could expose the rottenness of the system.
So, we sent the patients back to hospital, further highlighting the dysfunction of the HSE at the time. They had to pay us a penalty for terminating the contract prematurely, which cost them more than running it for the subsequent two years.
Working for the HSE he found innovation was met with suspicion: ‘the hospitals want to hold onto patients because without patients occupying beds, they can’t justify their budgets.’
And because budgets are pinned to occupancy and the size of the facility, hospitals seemed slow to manage overcrowding at the cost of lesser funding.
Fair Deal?
He argues that we should ‘evolve to a place where we simply don’t treat people with certain uncomplicated infections in hospitals, like in Canada and Australia.’
Now, he says, the only fast track for vulnerable patients is into a state or private nursing home, which is excessively expensive, ‘or their home is taken from them in what the government very cynically calls a Fair Deal:
someone works all their life, pays taxes, builds a home for their family, and contributes to the state and to society. But when they get ill, go into a nursing home or require dignified care the state wants to take their home from them to pay for that care.
Moreover, despite earning huge praise from patients, peers and when he presented the scheme to the NHS in the UK, he found the HSE ‘were always finding fault with what we were doing.’
‘I became used to that,’ he says ‘and very quickly realized the only thing the Irish public system does very well is perpetual dysfunction. It manages to procure massive budgets from the State, and despite this consistently overspends,’ despite ‘terrible outcomes for patients.’
He suggests that it takes ‘a concerted effort to continually do health as badly as we do in Ireland’, a system of public health, ‘with such huge budgets for such a small population.’
He says it is important to question why, given a very small and young population, ‘half of that population pays out of pocket expenses, approaching €2 billion, for private health insurance.’ He reckons this is ‘to protect ourselves from the dysfunction of the public system.’
🚨A record 908,519 people in Ireland are now on some form of a public hospital waiting list to be treated or assessed by a consultant. Meanwhile Gov lacks meaningful action on addressing capacity deficits #CareCantWait @DonnellyStephen @mmcgrathtdhttps://t.co/8ye5e4DoWw
‘It’s a very simple problem,’ he says, ‘too many of the same actors are involved in the public and private systems.’ The analogy he uses is of two separate doorways in a clinic: the public and the private:
You knock on the public door, and say, “Look, doc, I’ve got a terrible hip. It’s really hurting me. And he goes: “Yeah, you need a relatively simple, hip replacement, but it’s going to be probably three, three and-a-half years, because the system is overloaded.”
But the doctor adds unless of course you’ve got health insurance. So you say, “OK, I’ll go and get health insurance.” But by this stage you are too old to avail of this. But what are you going to do now, as your hip is only going to get worse?
You’ve been to the first door, where you met the doctor in the public system about the hip, who we’ll refer to as Dr Jim. Then you go ten feet down the corridor and knock on the door. “Who’s there? Why it’s Dr Jim again!’” And you say “Hey, Dr Jim, you just told me that you couldn’t fix my hip for three years.” and he responds: “not exactly. I can fix it if you pay me via your insurer.”
In a country of five million people, we have almost one million people waiting for care of one sort or another in a public system, which is one of the best funded systems in the developed world.
And, Bowes says, ‘it just so happens that the man running the show, Paul Reid, has no specific health care experience, for example. The UK’s NHS employs around 1.4 million people to serve a population of nearly 67 million. Its CEO Simon Stevens is paid €210,000 a year, while Ireland’s HSE employs around 102,000 people with a population of only 4.9 million, Reid is astoundingly paid over €426,000 a year.’
We have hundreds of people who work for the agency on long term sick leave. The dysfunction runs into every fractional part, IT, training, resourcing, recruitment, and services. The dysfunction is almost at a cellular level. But again, we are consistently told that we can’t land the jumbo jet to fix it, because if we do that, what will happen?
COVID-19
When COVID-19 landed, Bowes says, ‘with the stroke of a pen, we bought up every single private bed in the State. This occurred despite people saying since the foundation of the State, “Oh, you know, you can’t publicize the private, it would never work, but it was done overnight because the will existed.’
Health policy in Ireland, he says, reflects:
the laissez faire attitude of a class of people who are running the medical system, advising the agency and the legal system. They of course all have health insurance. I don’t know anybody who served on the board of the VHI or any doctor working in the system who doesn’t have private healthcare. I myself have to admit that I took out private health insurance purely because I know how difficult it is to access care via the public system. It’s sad but true and I am lucky enough to be able to pay, unlike more than 50% of the most needy In our society who cannot.
‘Irish People’ he says are dying ‘for the lack of basic diagnostic care.
Bowes muses on how: ‘The further up the pyramid you go around a health product in Ireland, the less you hear about the patients. And when you get to the board level, patient outcomes are in some way superfluous to the real issues, which are profit and the market.’ He argues that there ‘isn’t a single private provider in the country here’ which ‘isn’t preoccupied with profit.’
He says:
We’re happy to ostensibly starve a public system and propagate a private system which is absolutely predatory on the dysfunction in the public system. And in many, many cases, the people providing the care in the public system also have been or currently are providing care in the private system.
That’s our medieval, dysfunction and immoral system. It’s actually, and I don’t use this term lightly, an apartheid system. We have a segregated, apartheid system in health care. It simply isn’t based on needs of the patients. Ok, obviously, if someone’s at death’s door, they’re going to get seen, but I’m talking about this grinding dysfunction, where both sides are nodding to each other as they pass each other in the night, knowing that it’s so wrong. It’s so wrong. There are super doctors out there, super surgeons, super nurses and staff operating in the health system. It’s definitely a case of lions being led by donkeys.
Really encouraged by response of a leading figure in Irish culture over the past 50 years. "Daniele's interview with Fr.McVerry is classic. Cassandra is rapidly becoming the most important vehicle for ideas in the land." ***@danieleidiniph1@BowesChayhttps://t.co/7N1bz38X77
Bowes muses ‘I have no problem with doctors wanting to make a decent living. You’ve got to pay people appropriately. But now we’re flooding the system with locums from overseas who are often poorly trained and have poor English and patient interaction skills .’
And points to another ‘incredible dysfunction, which is again, state sponsored.’
We train more doctors than any other country of our size in the world, but we export them to Australia, New Zealand and the UK. It costs the state a significant amount to train these guys, and then they can just catch a plane to Bondi Beach. Of course, we can’t force people to work here – no more that we can force a health care worker to take a vaccine – but there are ways to incentivize the system, and develop better methods of training doctors, because we still use the archaic Leaving Cert as the basis for deciding who we train as doctors.
He also wonders:
How is it that while we train more doctors than anyone else that we are importing more doctors and nurses than anyone else? Countries like the Philippines, India and others are being bled of their precious nursing and medical staff to come to Ireland to look after our sick. There’s something wrong, right? But in the Irish system nothing changes. No wants to take on the vested interests. No one wants to take on the big personalities in health care and medicine. The political nexus between medicine, law and politics in Ireland is so tight because of insular practices and local allegiances trumping national welfare with some of the biggest political donors and influencers being waist deep in the sector.
He wonders ‘Who’s going to challenge the vested interests and speak out for vulnerable patients? The CEO of the HSE? Absolutely not. The past CEOs of the HSE seem to be only good at one thing, which is saying, “We’re trying…” But they walk out at the end of the end of their contracts with a big pension and usually into guess where? Yes, you guessed it, the private sector.’
He reveals how ‘a former CEO of the agency said to my face that he was the most powerless man in the health system.’
Image (c) Daniele Idini
Dysfunction Funds Profit
Bowes wonders:
How can you operate a business with a hundred and twenty thousand employees and seem to be powerless to sack people for not delivering, or in many cases simply doing their job wrong? Where’s the accountability in that system?
How can you amalgamate numerous health boards which are operating as satellites into a single “dynamic entity” and nobody loses their job? Not one manager is made redundant. Not one of them is even sanctioned.
How can a health system pay out tens and tens of millions in malpractice claims for egregious malpractice and incompetence in both governance and clinical care? For essentially killing women who are pregnant by denying them an abortion? By condemning young women to terrible life ending illness by failing to diagnose their cancers? How can you pay out these tens and tens of millions again and again, year after year, and nobody is sanctioned for it? How does that work?
It works because the dysfunction funds profit, and that profit is harvested by vulture funds, by private hospitals and private investors, by their legal advisors, some of whom don’t even pay taxes in this country, and who pays the price? The citizens that languish on public waiting lists accruing ill-health because they can’t pay for treatment. The man with the simple requirement for treatment, he’s invisible to the system, he is superfluous to the profit motive.
The poor he says have no bargaining power because:
the bargaining power is money and influence, and the people who have the influence to change the system are receiving huge salaries to manage and essentially perpetuate dysfunction. Again, the private system predates on the mismanagement of the public system. If it functioned there would be no need for a private system, right? Therefore, you have to wonder, who does the current dysfunction benefit? It’s an easy one: the private providers. But nobody who is of the machine is working against it. No one in Leinster House is saying to the CEO of the HSE: “What are you doing for your four hundred grand? We’ve got less intensive care beds per capita than Lithuania or Latvia. Two years into a pandemic, we still don’t have a dedicated COVID hospital which is just insane.
Apparatchiks of a state system who’ve worked, like Paul Reid in state jobs are seen as a safe bet. They’re nominated in as managers, managers of dysfunction, gatekeepers for their political sponsors and marked for future cushy roles on the private side of the wall.
Image (c) Daniele Idini.
Perpetual Crisis
He adds that ‘things like this mysterious and much vaunted “Cyber Attack”, which apparently “destroyed the abilities of the system” seem to be a perfect excuse to deflect from the internal failures of HSE management and external incompetence of its political masters.’
Bowes says: ’what I know, and anyone that has worked in the system knows, is that there was and is no viable system to attack.’ The HSE have ruminated for decades on the implantation of an electronic patient record: they have spent millions evaluating, re-evaluating, procrastinating, and failing to implement a viable solution.
Months after this “Attack”, you’re still running Windows 1998. Somebody needs to be held accountable.
But, he says: ‘the Minister doesn’t talk to the to the HSE, the relationships between the “Three Masters” of Health are utterly flawed, the Department of Health is cumbersome and cautious, the HSE is a lumbering leviathan with no real direction other than self-preservation, and the Minister is preoccupied with surviving a potentially career ending stint in the mire of the Irish Health system.’
Consider this, with such a huge annual Health budget and such poor outcomes for patients alongside such terrible value for money, the dysfunction and paying for it becomes central to the rational of the organisation. They actually need this dysfunction. Without the dysfunction, they’d be screwed because there would be an open accounting of what we’re doing in a system which is delivering horrendous results.
He also criticises Stephen Donnelly’s policy of giving more money to the National Treatment Purchase Fund, which sends public patient overseas for treatment, arguing that ‘this is not the same as a really equitable national health system where everybody gets treated on the basis of need.’
He says that people could argue that in a free-market economy if someone wants to purchase health insurance it’s up to them: ‘However, that’s different to paying almost half a million a year to a CEO to perpetuate a dysfunctional system.’
He says the HSE is only interested in crises, ‘in things like COVID’ and saying ‘but COVID is why the system is screwed, or we’re dealing with the cyber attack, which has caused this perpetual dysfunction, which is, you know, all entirely untrue.’
His conclusion is ‘the managers, architects and political apologists for the segregated and morally bankrupt system have done an exceptional job of screwing the Irish people out of their tax dollar and their rights to health and dignity. I’m not sure they are capable of doing anything else. It’s time to demolish and rebuild.’
