Consultants’ strike threat - Two-class health system must end

The medical profession was the target of some of Groucho Marx’s best jokes, as in “I’m not feeling very well; I need a doctor immediately. Ring the nearest golf course.”

He likened a hospital bed to a parked taxi with the meter running. Less humorously, he was pointing to the centuries-old and inseparable conjunction of medicine and money, a reality with which governments in all modern democracies — not least our own — struggle. There is no such thing as a free healthcare system.

It has to be paid for by either the State via taxation or privately insured patients, or a balanced partnership thereof that’s seen as fair to taxpayers and healthcare workers and the very best possible for patients.

Ireland’s model remains unbalanced, as highlighted by the Irish Medical Organisation’s (IMO) consultants’ strike threat and the cash and staffing problems evident in our hospitals.

The Government’s offer to consultants — salaries of up to a not unattractive €250,000 for those who commit to working only in public hospitals — is a welcome and long-awaited attempt to introduce equity into our failing system.

Politicians and the public are understandably frustrated by an arrangement in which 15% of State-funded hospital beds are taken by privately insured patients while those who find private health insurance premiums beyond their means wait on trolleys and ever-stretching lists.

Subsidising the private healthcare insurance sector is not the legitimate business of the state, and the Government is to be congratulated for at long last insisting that it has to stop.

No blame at all for this flawed system should be laid on those who buy private health cover, many of whom on modest incomes would prefer not to.

They do so nevertheless because they justifiably lack confidence in the quality of the care the State sector is able to provide. In a free and mixed economy, people have the right to spend their money how they wish.

If the public health system is seen to be failing, families cannot be expected to subordinate their own health and wellbeing to the grand and sacred ethics that rightly underpin the provision of social care.

What has to be changed, however, is a structure in which the State helps to fund a two-tier service — a first-class one for the privately insured and a second-class version for the rest.

The strike threat by the IMO and junior doctors might have been averted or at least softened if the Government had laid out its proposal in negotiations instead of announcing it initially in the Dáil.

But this is an administration not best known for its bedside manner. What matters now is that both sides meet to resolve a dispute that will achieve nothing whatsoever for our health service and all who need it.

It is worth noting that by sheer happenstance, the Government’s radical proposal and the consultants’ strike threat have surfaced just as staff at a Dublin maternity hospital have publicised a fundraising appeal for an essential €76,500 heart ultrasound machine needed in its intensive care unit.

It’s an appeal to generous donors because there is no cash in the Government’s budget for it.

Perhaps our health insurance companies might want to chip in?