SF councillor calls for special budget health provisions

BY ROBBIE MacGABHANN

How would you describe the 26-County health service? Could it be one that was ``flawed and inequitable'', and one on which 95% of the population thinks more government money should be spent? Two studies within a week have laid bare, for the few who might not yet know, the dire state of the 26-County health service.

The Economic and Social Research Institute (ESRI) report was a survey of 3,000 households, while the Harvard study was done by 50 management professionals who interviewed key personnel in the health service such as patients, GPs, hospital managers and consultants.


DOUBLE STANDARD

The ESRI survey found that only 43% of the population think the health service is good; the remaining 57% deem the public health system as being adequate, bad, or very bad. These figures were in stark contrast to the perception of the private health system. 83% of households thought that the private system was good or very good and 88% of people believe that private patients get hospital treatment more quickly than public ones.

Results from those surveyed found that waiting times were significantly shorter for private patients. 20% of respondents with medical cards had to wait more than a month for hospitalisation compared to 9% of those with private health care insurance.

Responding to the ESRI survey, Sinn Féin county councillor Noel Keelan said: ``The public have consistently said that health care is a priority issue for them. Yet the government has failed time and again to address this matter. This year's budget must include adequate allocation to tackle this effectively. Providing tax breaks for the rich at the expense of investment in the health service will no longer be accepted.

``There is little doubt that our health system is in crisis. Sinn Féin will ensure that this will be an election issue. The budget will be Fianna Fáil's last chance to reverse their atrocious record on health.''

HARVARD STUDY

The issue of waiting lists and how they are measured was central to the Harvard University study. Their report was a damning indictment of management practices in the Irish healthcare system.

For example, the Harvard consultants found that waiting times for hospital procedures are actually much longer than officially stated. They found not only was the system ``flawed and inequitable'', but that there was an unofficial three-month waiting list.

The Harvard team has called for the establishment of a single 26-County waiting list as the imbalance in facilities and concentration of consultants in the Eastern region is skewing the waiting lists. The study calls for the list to be administered directly by the CAO and be viewed as a website by both doctors and the general public.

This highlights a clear need for quality regionally based health services. It has long been the case for example that the only breast cancer screening facilities are in Dublin leaving women from outside Dublin long journeys and long waiting times for what is a relatively short medical procedure.

However, the real evidence of bias uncovered in the study was between those who are in the public and private system. Public patients are being marginalised. The survey found that if a patient is referred by a GP for treatment by a consultant the first question asked is whether the patient is insured or not. If yes, they can visit a private clinic, get treatment and the process is complete.

If the patient is not insured, they go onto the unofficial waiting lists, with an average duration of three months before they are even given an appointment for a consultant. Patients are then rated on severity of condition; if the problem is not severe, patients could stay on lists for months or years.

ETHICAL RESPONSIBILITY

When patients join an official waiting list, they are rated on the severity of their condition. If rated urgent, the patient is scheduled for surgery, but only if a bed and theatre are available. If a bed or theatre is unavailable the patient returns to the official waiting list.

The Harvard researchers believe that the Dublin government has an ``ethical responsibility'' to guarantee ``timely universal access to the acute system on the basis of clinical need''.

Perhaps the most telling aspect of the Harvard study is that it reveals how there are 30,000 people on hospital waiting lists today, the same number as there were in 1993. Since then, the Dublin government have spent £124 million to tackle this specific problem and there have been seven government policy reviews.

It is startling then, that it takes such a study now to tell us not just of the chronic inefficiencies in the system, or of the ineffectual government attempts to fix this, but of the huge inequities of the 26-County health care system.

I t is clear from both studies just what the problem is, and that the vast majority of the population know what the problem is, but has the Dublin government finally got the message?