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Ireland's political and cultural magazine
8 November/December
Part One: Ó’Tuathail and Bowes
and a Community not-for-
profi t.
“What is your home address?”.
C
HAY BOWES recently went back to col-
lee to study for a master’s deree in
strateic studies. He’s had a success-
ful but frustratin career in our health
services and tells me he’s “always
been interested in a disciplined and strateic
approach to the public interest and public ser-
vices”. Failures in these areas have led him to
tell his shockin story.
After school in Dublin, Bowes joined the army
medical corps in 1988 and trained as a para-
medic. From 1993 he worked as a phlebotomist
in St James’s Hospital in Dublin, drawing blood.
He says he was very aware of a systemic pattern
of too many people entering and staying in the
hospital when they would have been better o
at home: “The fi nancial and clinical benefi ts
are well known. Research shows up to 30% of
patients would be better at home. It’s an idea
whose time has long come”.
But, according to Bowes, “Hospitals are insti-
tutions and institutions do not lightly shed their
historic functions”. The government’s overarch-
“Leo always
delivers”
by Michael Smith
WhatsApp correspondence shows Varadkar
transferred confi dential IMO contract to rival
medical organisation, a crime under the
Offi cial Secrets Act and maybe under the
Corruption Act, carrying a penalty of up to
10 years in jail and prohibition from offi ce
NEWS
ing health policy Sláintecare, at least aspiration-
ally, prioritises this shift.
He says one of the most impressive people he
encountered in Medicine was Gerry Mac Elvaney,
a Professor in the Royal College of Surgeons and
then in Beaumont Hospital, who had worked
in Walter Reed Hospital, the saviours of Trump!
Bowes approached him and the two of them
pioneered moving the care of patients out of
hospitals into the Community in 2004 through a
company called Tara Healthcare. It became a no-
table commercial success so after a successful
HSE contract ran its course and the HSE stopped
funding it for its own reasons, the VHI, seeing a
good thing, bought them out.
He says “We did okay out of that and I became
CEO of the new company, VHI Hospital@home,
the clinical care arm of Ireland’s largest health
insurer”. He says he reluctantly left the VHI in
2011 and pursued other non-related interests for
six years.
By 2017 Bowes’ appetite for the healthcare
sector had returned and, with healthcare entre-
preneur Neil Pope, he set up another company
to again bring back the idea of Community Care.
It was called Community Hospital Ireland (CHI).
This was to be a not-for-profi t company with all
proceeds being ploughed back into the Commu-
nity to prevent chronic illnesses like diabetes.
The proposal seemed initially to have broad in-
stitutional support within the State and clinical
“Leo always
Bowes Blows Whistle
Insider Chay Bowes blows the
whistle on how a doctor befriend-
ed Leo Varadkar and boasted
how Varadkar illegally leaked him
valuable con dential information
about IMO negotiations; and how
vested interests subvert the com-
mon good in public, as opposed to
private, healthcare.
VILLAGE GETS ACCESS TO INSIDER TROVE OF WHATSAPP MESSAGES.
November/December 9
leaders. Leo Varadkar, as Taoiseach, supported
it. His Private Secretary wrote to Bowes in July
2018 stating: “Your proposal aligns with the Gov-
ernment’s intention”.
Bowes was looking for partners, especially in
the GP sector. So he strategically approached
Maitiú (Matt) Ó’Tuathail who was then the
29-year-old president of the National Associa-
tion of General Practitioners (NAGP) allegedly
representing 2000 GPs, in competition with the
larger, famously well-funded and more general-
ist Irish Medical Organisation [IMO].
There was bad blood. The NAGP was radical,
dynamic, younger. According to a recent article
in Medical Independent. “The NAGP quickly es-
tablished itself as very media-friendly, with regu-
lar press releases, strong spokespeople, and a
number of high-profi le campaigns”.
It was challenging for the IMO. The NAGP
needed to poach members from its rival. To do
this required it to call the IMO to account for ne-
glecting to represent General Practice.
The di erent agendas of the competing rep-
resentative bodies came to a fl ashpoint when
Varadkar’s government excluded the insurgent
NAGP from the most crucial discussions a ect-
ing GPs in a generation. The IMO declined to of-
fer Village a view on the relationship at the time.
These were over the agreement on GP Con-
tractual Reform and Service Development and
the IMO claimed rights as the long-established
senior body to the role of sole negotiator - to
the dismay of the NAGP whose members’ liveli-
hoods too depended on the outcome.
On March 2 2015 the Irish Times ran a story
headlined ‘Doctors’ union says exclusion from
GP contract talks is “Stalinist”’. The NAGP was
spitting mad:
“The NAGP has urged its members not to
sign up to any proposals for the provision of
free care to under-sixes and described it as
‘misguided, inequitable and unworkable’.
Minister for Health Leo Varadkar told the
Sunday Business Post: ‘The Department
remains willing to engage with the NAGP
but given (the NAGP’s) stated position that
government’s policy on extending GP care
without fees is immoral, and their call for a
boycott. It is hard to see any real basis for
Leo Varadkar, his partner Matt Barrett, his friend Matt Ó’Tuathail and
others take time out in photographs forwarded by Ó’Tuathail to Bowes
Matt Ó’Tuathail is a well-meaning, progressive
and talented individual who has been doing
his best for the health system and particularly
highlighting the demise of general practice. He
is also now developing a high public profi le as a
trusted opinion-former, including on Covid.
“engaged for a number of days each week for
the past three months with the Department and
the HSE”, the insurgent NAGP organised a press
conference and a protest, subverting the nego-
tiations.
Dr Andy Jordan, NAGP chairperson, was un-
dermining the IMO insisting not just that the cuts
needed to be fully reversed but that there was
a need for increased funding of €400 million to
€500 million in order to make general practice
sustainable.
All in all, to Bowes, as of April 2019, Ó’Tuathail,
with all this savvy and passion, seemed like a
dynamic and open force in the health sector. In
the end it turned out he brought too much politi-
cal baggage.
Ó’Tuathail liked the idea of Community Hospi-
tal Ireland.
It was a noble idea and Ó’Tuathail felt he could
help push it to the government. “I can get this
in front of Leo and Simon”, he told Bowes. “He
showed me text messages from Leo Varadkar,
then Taoiseach.
Bowes says: “For some reason he sent me
photos [below] of Leo, Leo’s partner Matt Barrett
(who is a youthful cardiology consultant in Denis
O’Brien’s Beacon Hospital) and Ó’Tuathail social-
ising - sometimes knocking back pints - together.
This was a guy with connections”.
Bowes says that Connemara-born Matt
Ó’Tuathail is a well-meaning and talented in-
partnership at this time. For these reasons
a memorandum with the IMO has been
signed’.
‘Obviously we no longer live in a demo-
cratic society. In the Stalinist-style state we
now live in, if you question Government pol-
icy, your views are silenced by any means
possible’, said the organisation’s chief ex-
ecutive Chris Goodey.
‘The Minister has come up with one sham
reason after another to justify this discrimi-
nation against our members. He has fi nally
admitted that the real reason we are being
excluded is that we have refused to be bul-
lied into accepting a policy that is driven
by political need rather than the common
good’”.
The IMO and NAGP were enaed in an
institutional knife fi ht.
By 2018-19 it was being reported that the draft
negotiated by the IMO was addressing the cen-
tral issues for GPs of reversal of the €210 million
in long-standing ‘FEMPI’ cuts and preparation
for the overarching new health strategy, Sláin-
tecare.
The NAGP needed to steal some of the IMO’s
thunder, disrupt its self-gratulatory smugness.
Against this background on 6 February 2019,
just as the IMO was saying its talks with govern-
ment were getting “intensive” and the Medical
Independent reported that the IMO had been
