Dreading what becomes of the health system
Further afield, Brexit and the imminent accession to high office of Donald Trump are dominating the airwaves.
However, for those of us over a certain age, the health situation is the one that should cause most concern as it will directly impact on the quality of life of the ageing population.
I read a piece over the holiday period that looked at a long list of recent health ministers and the conclusion reached is that all have failed.
Whether that assessment is correct or not depends on one’s definition of the word failure.
If we judge failure in this context as a situation where access to proper healthcare is not available to all and where long waiting lists for vital surgical procedures exist and where patients have to spend even one night on a trolley, then indeed they all have failed.
The fact that they have failed should tell us something because at least a couple of those ministers actually had some ability and more importantly a strong desire to sort the crisis.
This begs the question if a solution to the crisis actually exists.
We need a proper debate on the amount of money we spend on the system; the remuneration of those who work in the system; the balance between public and private financing of the system; and if the monies being spent achieve either the efficiency or equity goals of the population.
All sorts of theories abound about equity and inefficiency in the healthcare system.
Some argue that administration simply soaks up too much of the available resources and frontline services are consequently deprived of sufficient funding.
Others argue that we simply do not spend enough money on the system and that the bed closures that have been implemented in the name of fiscal austerity have delivered a system that simply does not have the capacity to meet demand.
Others believe that our primary healthcare service is simply not adequate to cope with demands and that many who present to the hospital system do so because primary healthcare is inadequate.
The truth is that the failure of our health system is due to a combination of these and perhaps other factors. However, on top of these issues, I believe that we have nurses in the system who are paid very poorly, but more importantly lack any semblance of career path or prospects.
Nurses were treated poorly in the very flawed benchmarking process 15 years ago, and their relative situation has deteriorated further since then.
It is no surprise that we do not have enough nurses in the system and that many of our trained ones are moving overseas to be properly rewarded and appreciated.
In theory, a proper health service should be one where everybody in real need should have quick access to the system and receive the treatment they require in an affordable, effective and efficient manner.
This is easier said than achieved. In 2017, it is envisaged that Ireland will spend €14.6bn on gross voted expenditure on health, which is equivalent to just over 25% of all voted spending.
The problem is that the ability to increase this sum significantly will be constrained over the coming years, not least due to increased demand for spending in all other public services. I dread to think what it will be like a decade or two down the road.
The depressing thing is that as our population grows and ages over the next couple of decades, the demand for more and better health services will obviously grow.
If we cannot cope with our current demographic age profile, then I dread to think what it will be like a decade or two down the road.
I am told and I am inclined to believe that one of the big issues with reform of the manner in which health services are delivered is the myriad of strong vested interest groups within the system who are more interested in protecting their own patch rather than accommodating real change and reform.
I fear that Simon Harris will be added to the failure list unless dramatic reform is engineered as quickly as possible.
