Proposals don’t go far enough

THERE is no denying a radical overhaul of the health service is long overdue.

However, it is doubtful that the recommendations before the Cabinet represent a magic wand for the tens of thousands of patients languishing on hospital waiting lists.

Politically, the proposals would dramatically change a system whereby elected representatives treat the health service as a personal fiefdom, often ignoring the advice of medical experts to advance their electoral ambitions.

Effectively, by breaking the grip of politicians, with all that implies for local democracy, Health Minister Micheál Martin would establish the kind of central control over spending Finance Minister Charlie McCreevy is demanding.

An outrageous example of gross over-spending in healthcare was highlighted on Joe Duffy’s Liveline programme yesterday. Listeners heard details of a VHI bill totalling €12,764 for a 20-minute angioplasty operation, including a whopping €6,721 charge for an overnight stay in a hospital room shared by three patients.

At the other end of the scale, Special Olympian Aidan Downey, a basketball player, has learned to his dismay that health cutbacks will deprive him of his place at a training centre near his home in Tipperary after the Games.

No wonder Ireland is getting a growing reputation as a country where people with disabilities are militated against and the health service is priced out of the reach of ordinary people.

Besides creating a more rational forum for decisions on health matters, it is vital for Mr Martin to take on powerful interest groups such as the consultants.

For too long, public patients have had to endure a two-tier system, often waiting years for medical treatment while those who can afford to pay get a fast-track service based on chequebook medicine.

There is no guarantee the planned overhaul would save money by reducing the widespread duplication of medical procedures in hospitals.

Effectively, if the recommendations contained in two reports from expert groups were implemented tomorrow, it would result in politicians being removed from the country’s 10 health boards. The boards would then be re-shaped into four regional bodies.

Arguably, the package does not go far enough. Significantly, the public has yet to see a third report, an even more important document aimed at transforming the country’s hospital service.

It would see the Government having to take highly controversial decisions on the re-allocation of specialist services and the possible closure of some hospitals.

But with local and European elections looming next summer, the report is likely to be long-fingered. It would be a political hot potato for Fianna Fáil and the PDs, who could be blitzed by single-issue candidates campaigning against unpopular hospital closures.

Because of such limitations, the package before Government is likely to fall short of the root-and-branch shake-up required to transform the country’s ailing health system into Mr Martin’s promised “world class” service.

Essentially, the McCreevy-Martin approach will see health spending tightened through greater accountability and better control of budgets.

However, unless the Government grasps the nettle by taking on consultants, reforming hospitals and investing in the future of the health service, thousands of long-suffering patients are doomed to endure waiting lists, closed beds and cutbacks for years to come.