Overhaul must bring real benefits

The Cabinet will tomorrow receive proposals jointly from the Ministers for Finance and Health, which are being billed as a major thrust to radically overhaul the health system.

Both ministers will be seeking government approval to fundamentally change the way the system is managed and controlled which would, if ratified, represent the biggest change in the health service since the early 70s.

The fact that the Minister for Finance is one of the architects of this move signals that the Government is ready to embrace the radical changes contained in the proposals, although politically there is resistance because the perceived power of local politicians on local health issues would largely be removed.

The general public will certainly welcome a move that will extract layers of bureaucracy from the health service, such as the removal of over twenty of the 55 agencies that are currently involved with the day-to-day running of the service.

The sweeping changes proposed would see the abolition of health boards, the creation of a new national health service executive and a new National Hospitals Agency to take over control of the country’s acute hospitals.

With the disappearance of the health boards, to be replaced by fewer regional health agencies, the role of local politicians will be diminished as locally controlled agencies will be managed by executives.

Effectively, brokering health services for their constituents who either are, or not, entitled to them will be taken away from politicians who see such influence as a vital aspect of their electoral chances.

In a system which is costing the taxpayer over €9 billion a year, services should be provided as a matter of entitlement by professionals, rather than on the intervention of Dáil hopefuls.

There could also be job losses because the pruning of the health service into a better shape to meet the pressures exerted on it, could see hundreds of people on contracts lose out.

These will be evinced in areas other than the medical sectors, which badly need to be bolstered to bring the service forward into a more streamlined and value-for-money one.

There is still a very high vacancy rate in the area of nursing, for instance, despite recruitment abroad, with almost 1,000 jobs unfilled at the start of this year, according to the Health Service Employers Agency.

There has for far too long been a deep-rooted dissatisfaction with the health service as it is currently constituted, considering the billions of euro being poured into it.

Now that the two ministers have seemingly put their differences aside, their joint approach offers an opportunity to transform our health service into a more practical and manageable structure.

If their pragmatism in relation to a re-vamped one is accepted by the Cabinet tomorrow, it will be published on Wednesday which should allow for a reasoned and practical debate on its merits.

Effectively, re-structuring our health system is a bold step, but something which has been needed for too long.

The direction in which both ministers want to take it, would, initially seem to be correct and warrants a clear-headed debate, based on what is best for the country’s health, rather than sectional interests.