We aren’t good at joined-up thinking in this State.
As we move from depression to recovery, now would be the time to put in place some of the elements to solve long-standing issues. All the evidence is that the State won’t, as it seems to be immune to evidence-based policy.
Four areas highlight this tendency.
Take the health crisis. The epicentre of concern is around the disgrace that is the trolley system. People spending hours or days on trolleys or chairs is unacceptable. They can’t be accommodated in wards for two reasons. One is the effect of the cuts. We have 2.9 beds per 100 persons, versus the OECD average of 4.2. In real, purchasing power adjusted terms, we spend 6% less per capita than the OECD average on health.
Above that, however, we have a dysfunctional pipeline. People end up staying in acute hospital beds because there is nowhere they can be safely discharged. Having cut back on home help, and having outsourced nursing home provision to the private sector, elderly and ill people, who could be in situations other than acute beds, remain there. And then thesystem clogs up. The obvious solution, of opening wards and restoring home-care packages, seems not to be on the table — little evidence of joined-up thinking.
A second and third set of issues are in the education area. Structured, professional, early childhood education and care pays dividends later in life in social, economic, educational, emotional and health benefits. A 2012 Oireachtas report lays out this in very clear terms. A return of 16-fold over expenditure is not unusual. It also lays out the components of excellence. Again, we are not carrying through. The total public spend is less than two-thirds the OECD average on child and pre-primary education and care. Thus the burden, again, is outsourced.
Irish childcare costs are eye-wateringly high. As a percentage of average wages our childcare cost is typically twice that of the EU or OECD average and is the second highest as a percentage of family net income, 2.5 times the OECD or EU average. The burden is disproportionally higher for lone parents. As a consequence Irish children are less likely to be in formal childcare than the OECD or EU average, and to spend less time there. Irish grandparents are more likely to be informal childcarers than others in the OECD. There is nothing wrong with informal childcare — but it should be a choice and the evidence is that it is usefully complemented with formal structures. A further element of excellence is that childcare and early childhood education workers be professionals, and paid as such. Yet the evidence is that they are not, with many earning barely over the minimum wage. So, we have a sector that pays enormous dividends, where the State will not invest, and which is structured to be inaccessible or enormously expensive for families.
Children grow up, however they are educated and many of them go to university. Irish universities have had enormous cuts in spending over the last half decade, while increasing output. Despite the evidence that we spend less as a percentage of national income than the average OECD nation, and have not increased the share of spending since 2000 (in contrast to the OECD average), there is an unwillingness to face up to the looming educational crisis. The boom in children now emerging in primary schools will translate, inevitably, into increased demands for third-level places.
Every independent examination of the finances of the sector concludes a need for greater sustainability and a certainty in funding. Some form of student contribution will inevitably be part of this, yet successive governments have kicked to touch. Much is made of a commitment to increasing educational attainment at this level by not excluding people due to fee requirements. This is in contrast to the evidence that there was little sustained increase in access consequent to the removal of fees. Again, evidence is ignored when it is politically inconvenient.
We are poor at evidence- based, joined-up government and yet we keep electing those who deliver this dysfunction, while saying we want a functioning system. Our actions and our words are in conflict.
© Irish Examiner Ltd. All rights reserved