Low-cost, universal care is the least we should expect
On Wednesday, the Government finally launched the implementation strategy for Sláintecare, the cross-party roadmap for reform of the health service.
That was 15 months after Sláintecare was published.
While I do not doubt that Health Minister Simon Harris is genuine in his desire to implement the plan, the Government is lacking urgency.
That must change immediately, if this plan is to be fully realised. Reform costs money, and we need to see what the Government is willing to commit. We need a transition fund in the forthcoming budget that is separate from money for frontline services.
Sláintecare came about after the 2016 election, because health was the number one issue on the campaign trail. All politicians agreed that the system was broken, but there was no agreement on how to fix it.
In the past, this has led to short-term plans, which change each time there is a new minister.
But Sláintecare is different. It has come about because of a unanimous Dáil vote for all parties to come together and devise a strategy for a universal, public health service, comparable to those in most other European countries.
It is based on advice from health experts, patient groups, health professionals and other stakeholders. Despite the broad range of political views and ideologies represented in the Dáil, consensus was reached.
In the Committee on the Future of Healthcare, which I was elected to chair, parties agreed on the need for a universal, single-tier public health system, in which people will be treated according to their need, rather than their ability to pay.
This is the basis of the Sláintecare Report that the Committee on the Future of Healthcare produced.
For the first time in the history of the State, there is now cross-party agreement on what kind of health system the Irish public should have, and how we should achieve it.
If Sláintecare is properly resourced and implemented, it would mean that everyone would be able to access free, or low-cost public healthcare.
It would mean a legally binding guarantee on waiting times for procedures in public hospitals, and hospitals that miss these will be penalised.
It would mean moving the majority of care, things like x-rays and chronic disease management, away from hospitals and into community settings.
It would mean building a universal, public health service, which everyone is happy to use.
This isn’t some sort of pipe dream; it is the standard in the rest of Europe and most of the developed world. Other countries have shown that it is achievable and that it is affordable.
If the public were understandably muted in their reaction to the launch, a number of organisations were lining up with buckets of cold water.
Although, from the perspective of patients, our public health system is fragmented and broken, many vested interests are making huge profits off this dysfunction.
I question the motivations of people who say that the plan, which would deliver what is standard in terms of public health provision elsewhere in Europe, would not be possible here.
In Ireland, everyone is entitled to public hospital care, but the reality is that a great many people face very long waiting times for procedures and treatment.
The shocking figures we saw this week bear this out. One million people are now on waiting lists for health- and social-care services in Ireland.
On the other hand, about 46% of the population feel they have no choice but to take out private health insurance, in order to access health services that they are already paying for through their taxes.
Most people with health insurance are still required to pay for GP care, for diagnostics, to see a consultant and for medicine. If a public health system is of decent quality, people will not feel the need to pay for very expensive health insurance that does not really offer much beyond quicker hospital care.
I am optimistic about Sláintecare. It has cross-party support so that it should remain as our health policy, regardless of which parties are in government.
The next real test, however, will come in October’s budget, when the minister must commit to a dedicated, multi-annual funding stream for reform.
We will see, at that stage, if Fine Gael are serious about tackling the problems in the health service once and for all.
