Hospital co-location - Paper shows questions remain

BRIEFINGS for incoming government ministers, in the wake of the general election, reveal fascinating insights into the reality behind controversial policies and promises by the coalition with the aim of wooing voters at the polls.

By far the most revealing briefing paper yet to come to light following the recent election is from the Department of Finance. Drawn up to bring incumbent Minister Brian Cowen up to speed on a wide range of issues, its observations effectively touch upon the affairs of virtually every other department.

In a controversial twist, the most powerful government department, which holds a tight rein on the strings of the public purse, introduces a distinct note of uncertainty into the debate surrounding the vexed issue of hospital co-location.

Commenting on this political hot potato, the briefing paper notes that it requires “careful monitoring”. In a worrying observation as far as taxpayers are concerned, it goes on to say: “It is not clear what the cost will be of using any public beds freed by the creation of new private hospitals, whether the case mix will change or whether staff and equipment costs will arise.”

This goes to the heart of the debate on the benefits and disadvantages of co-location. The brainchild of embattled Health Minister Mary Harney, the thinking behind the co-location policy was that a line should finally be drawn in the sand relating to the contentious control over public beds by highly paid consultants for the use of their fee-paying patients.

For years, Ireland’s inequitable two-tier system of cheque-book medicine has forced thousands of public patients to wait interminably in never-ending hospital queues while those who could afford to pay for costly health insurance cover were fast-tracked through the system. Tragically, in some instances, public patients died while they were waiting for treatment.

Essentially, the aim of co-location is to free up 1,000 beds by moving private patients to wards in privately funded co-located hospitals, the first six of which are soon to be built in the grounds of existing public hospitals.

The air of caution running through the briefing paper from the Department of Finance is certainly worrying. On the face of it, it makes it abundantly clear that the cost implications of co-location are far from clear-cut.

According to Minister Harney, the National Development Finance Agency has advised her that tenders submitted for the first six co-located private hospital sites represent “value for money”.

It remains to be seen whether the same can be said of the co-location system itself when it comes into operation. For example, we have yet to discover the cost to the taxpayer of releasing 1,000 extra beds for public patients.

Among other issues of considerable public interest contained in the document refer to electronic voting and social welfare costs. We learn, for instance, that “budgetary constraints” will have a huge bearing on whether the Government can afford to deliver on its social welfare commitments.

Regarding the Coalition’s botched bid to introduce electronic voting, it reveals that 1,824 voting machines have been removed from warehouses in Dublin and Wicklow to Gormanstown army camp for storage. However, as the containers can’t hold this number of machines, it seems they will run out of storage. More bungling.

Whatever about briefing incoming ministers, this is the kind of stuff voters should be told before they go to the polls. That would be real democracy in action.