Our health service - Reform is about more than money
Even for an entity with a budget approaching €20 billion this is a significant figure, especially as the organisation is struggling to provide the service everyone, the HSE included, would wish.
The HSE’s finances are under tremendous and increasing pressure to provide medical cards for workers who lose their jobs because of the recession. Early estimates suggest unemployment will throw the HSE budget off course by as much as €40m this year.
However, if that prediction is as inaccurate as many of the others made about our economy in recent months — many of which had more to do with political campaigning and wishful thinking than reliable appraisals — that figure could well be dwarfed.
An unpublished Department of Finance report by the National Treasury Management Agency shows that 980 people manage HSE bank accounts and payrolls. Amazingly, the HSE had 254 accounts with seven banks. The HSE has commendably reduced that to 63 and now uses one main bank.
The agency found that many of the HSE finance staff carry out “duplicate” roles. That’s official speak for saying that there are too many people involved and that there’s no work for some of them. Maybe even less, since nearly 200 bank accounts were closed.
This is another manifestation of the bizarre and immoral political assurance that there would not be forced redundancies when the HSE replaced health boards. It is probably naive to imagine that waste and “duplication” is confined to finance. If there is similar sloppiness in, say, energy and fuel, or transport and property purchasing, €20m may be just the tip of the proverbial iceberg.
We have consistently argued against Health Minister Mary Harney’s every-man-for-himself plans for private hospitals believing that private enterprise is the servant of profit rather than the best conduit to a vital and universally accessible social service.
We also believe in the potential of a properly managed and reformed public health service to do the job.
It is inefficiencies like those unearthed by the agency — and brought about by politicians — that give momentum to the argument for a greater role for private enterprise in health. Therefore, confronting them is not just about saving money, it is about proving that the public service model can do the job.
Not so long ago it would have been impossible to even suggest that the difficulties undermining our health service were tolerated to bolster the argument for private sector opportunity. Every day that passes without the root-and-branch reform that we all know is essential and possible makes it difficult to ignore that possibility.
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