Having resigned the Ministry of State for Health, Roisin Shorthall posed some pointed questions in relation to what values should determine how Health Care is provided in this State.
During the Dail debate on the confidence motion in Minster for Health, James Reilly, Deputy Shorthall asked: ‘Who will bear the burden of the cuts? . . . Do we cut public health nurses or collect money owed by insurance companies? Are we going to reform and strengthen our pubic health service or are we going to privatise large parts of it? . . . What model of universal health insurance best suits the situation here in Ireland? Should it be a commercial insurance model or a social model?’
Three days later on RTE Radio the Deputy stated, ‘Dr Reilly is moving towards the American model, moving towards the insurance companies running the health service. . . I firmly believe he is going for the American model, down the private route.’ She is quite correct in this but she has a major credibility problem in implying that she stands for something completely different because this is precisely what she and The Labour Party signed up to when they went into government with Fine Gael. They also signed up for the bailout and austerity.
The Programme for Government 2011-2016 says: ‘A system of Universal Health Insurance will be introduced by 2016 . . .Insurance with a public or private insurer will be compulsory with insurance payments related to ability to pay. . . . Insurers will negotiate directly with hospitals to help control costs and encourage innovation in the delivery of care.’
The Programme goes on to say that, ‘Insurers will not take over the running of hospitals which will be independent providers of care separate from insurers as purchasers of care.’ In reality, however, a huge measure of control in health care would be handed over to private insurance companies. The Fine Gael policy document on Health published in 2009 and which was called ‘Fair Care’ spells out quite clearly what the reality would be under the proposed new system. ‘At the moment Ireland has two administrative systems for health – one public (the HSE) and one private (the insurance companies) . . . . over time these two systems of our Health Service will become one, run by the insurance companies.’
That last phrase ‘run by the insurance companies’ should come screaming off the page because it spells out that the government proposal does indeed involve a massive privatisation in health care. Public hospitals, says the programme for Government, would be cut adrift as ‘independent, not for profit trusts with managers accountable to their boards. . . Hospitals will be paid according to the care they deliver and will be incentivised to deliver more care in a “money follows the patient” system.’
What this means is that doctors, nurses and administrative staff in hospitals would be forced into a vicious competition driven by the imperative of the insurance companies to cut costs in order to maximise profits which is their primary purpose. This would inevitably distort the provision of proper health care which should be exclusively determined by the health needs of patients.
The government’s plans would mean extensive privatisation but would also inflict significantly increased costs for the growing body of taxpayers who currently do not have private insurance but rely on the public health system should they need hospital treatment. The Minister for Health often refers to the Dutch model of Health care which he wants to imitate. In Holland the premium for insurance for an individual person is around €1,000 per year while an average family can be forced to pay €4,000. If implemented in Ireland, this would be a new stealth tax and a new burden too far on working people who can endure no more as they pay to bail out the European financial system.
Despite the inconsistencies and limitations of the political position adopted by Deputy Shorthall, in resigning she at least took a stand on a range of important issues and especially on the need to develop primary health care. In stark contrast to this, the leadership of the Labour Party shamefully attempted to whitewash the grubby croneyism evident in the selection of primary health care sites and especially in the case of a site Balbriggan in north Dublin that is owned by a Fine Gael supporter and associate of the Minister for Health while another Fine Gael contributor was awarded the lease to develop the medical centre on this site.
In their previous lives in Opposition one can only imagine the shrill decibel levels that that would be reached by Labour’s Deputy Leader Joan Burton had this been a Fianna Fail ‘stroke’ while her leader Eamon Gilmore would be incoherent with apoplexy. Now, in the embraces of Fine Gael, we didn’t even hear muffled noises of protest.
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