BY ROBBIE MacGABHANN


     
The government's health strategy fails to recognise that ideally there should not be a market for healthcare. There should be one public free system
Four and half years into government and Fianna Fáil with their Progressive Democrat tail wagging, this week brought the state's media together to tell us that yes, there is a crisis in our healthcare system. It was a bit like an updated version of the emperor's new clothes. Bertie Ahern has suddenly admitted that his previous claims about our health service were fundamentally wrong and that yes, waiting lists are too long, yes, primary care treatment is deficient, and yes equipment and buildings are out of date.


QUALITY AND FAIRNESS?


So what's the next step for our dynamic coalition duo now that they finally have faced up to the problem? Quality and Fairness - A Health System For You is the solution. It promises us:

3,000 extra hospital beds over the next 10 years,

A decrease in treatment waiting list times,

A New National Hospital's Agency,

A New National Primary Care Task Force,

A Treatment Purchase Fund.

The coalition policy document also promised us the same old flawed two-tier healthcare system. The signs were all there in the detail of the new strategy.

For example, though there was a lot of hype about the proposed £10 billion in extra spending over the next ten years, Minister Mícheál Martin was not sure how much money they had to spend next year and the much-vaunted £10 billion over the next decade in extra spending is not guaranteed.

Yes, there will be 3,000 new beds, which in reality is only putting back into the system what Fianna Fáil took out in the late 1980s and Fine Gael and Labour in their sojourn in government in the 1990s forgot to put back in.

But the Irish Hospital Consultants Association believes there is a need for 5,000 new beds. With so much effort and analysis put into our healthcare system by the government, how can there be such a discrepancy between what they think is necessary, and what one of the major players in the health service think is needed?


FF FLAWS


However, this only touches on what is one of the fundamental flaws of the Fianna Fáil/Progressive Democrat health strategy. If there really were "quality and fairness" in our health service, why would we need to have a private sector health service? Surely it would become meaningless in the new era of an equal health service for all?

The reality is that the coalition plan is just tinkering with the system and at times bad tinkering. For example, a Treatment Purchase Fund is to be set up to buy bed space in private hospitals and pay for medical procedures from these hospitals as a means to cut public hospital waiting list times.

This week, VHI chief executive Vincent Sheridan voiced concerns that private hospitals might not to be able to provide treatment for the most common procedures on current waiting lists. Again, surely with so much effort put into this health policy, the coalition government must have known that the VHI had problems with their master plan and this is only one of them?


VESTED INTERESTS


One possible explanation is that the coalition government had to plot a middle ground through all the vested interests in the health sector when formulating their plan. This might explain why Minister Martin chose to ignore the findings of a report by Deloitte and Touche, which criticised the existing health board system where competing political interests on health boards were seen to have a negative impact on the value for money service of the boards.

The one vested interest ignored throughout the new policy, though, is the cocooned position of the private health system within the public. Bad enough that the state is already subsidising half the costs of private patients using public hospital facilities and that through the Treatment Purchase Fund it is to give more money to the private system. The Deloitte and Touche report also found that though the VHI have 20% of the beds in public hospitals, they only contribute 11% of the costs of running these hospitals.

Bertie Ahern told us that he wants "nothing less than a world class service for every patient". Well, he or Mícheál Martin have yet to explain how their proposals will bring this about if your income is still the key determinant of how quickly, how comfortably and how well you are treated in the health service.


NO MARKET


The real flaw in the Quality and Fairness strategy is this, it fails to recognise that ideally there should not be a market for healthcare. There should be one public free system, the best possible one with the greatest possible input from those it claims to service. The ten-year strategy should be one that seeks to transform the current failed system into the one-tier service that really is world class for everybody, regardless of how much they earn or where they live.

Until the coalition cabinet face up to this reality, all their hype about world class health will be just another twist in the emperor's new clothes story.

Sinn Féin's response to FF health strategy

MacManus appalled at lack of leadership

Sinn Féin's Seán MacManus condemned the Fianna Fáil-led government for failing the central test of the current healthcare crisis. MacManus said, "I am appalled by the government's lack of leadership on this issue. They have squandered the best chance this state has ever had to redress the structural problems of our health system".

"The plan does not fundamentally re-orient the system. It does not guarantee universal access to care based on need alone. The plan does not give us free primary care. It does not give us a single, prioritised waiting list ensuring that patients most in need get care first.

"Instead, this Health Strategy copperfastens the two-tier public-private system that has failed us to date. Even after this Health Strategy is fully implemented in ten years, we can still expect to have a situation where one's income will determine access, quality, and speed of care. We will still have a situation where many working people do not qualify for a General Medical Card, but also cannot afford private insurance. Therefore, we will still have a situation where many people cannot afford to go to the doctor, and cannot afford to take their children to the doctor. This is not leadership in health.

"The Irish people want radical change in the healthcare system. Sinn Féin is ready to deliver this radical change. But this government insists on clinging to an unequal system that does not work. What they have done with this Health Strategy is tantamount to calling for a protest vote on health. Fianna Fáil may not be committed to full equality in healthcare, but Sinn Féin is. Fianna Fáil may not consider health care to be a human right, but Sinn Féin does.