Republican News · Thursday 1 November 2001

PD proposals ensure health inequality

BY ROBBIE MacGABHANN

Of the all the possible policy solutions to the health service crisis, which do you think is the most unfeasible and inequitable? One interesting non-runner was a recent Progressive Democrats proposal that patients on public health waiting lists be treated in private hospitals with the government paying the tab. The PD proposal, in a slightly altered form, is to be discussed by the coalition government this week.

This might help ease waiting lists, while the government rebuilds the capacity of the public health care system it so cruelly neglected for the last decade after the ruthless cutbacks of the late 1980s that saw 20% of the beds taken out of the public system. However, it would also subsidise further an inequitable system that already has half the cost of private patients borne by the public system.

The Independent Hospital Associations of Ireland (IHAI), which represents the private health sector, has told the government it could treat up to 11,000 public health patients a year. The IHAI want three-year contracts to carry out this work and tax incentives to allow them expand their hospital network. Then we have a second outcome of the PD proposal - that is, a bigger private sector with more subsidies and ultimately a more unequal two-tier health care system.

The proposal to treat public patients in private hospitals to ease the misery of waiting lists does have some merit. However, whatever short run benefit it does confer will be offset by the perpetuation of the private system. Healthcare should not be a business run for profit, or for those who can pay before those who cannot.

The Dublin government is currently honing its master healthcare strategy. If it does not have at its core a commitment to a universal, quality free service, it will only lead to a policy of subsidising inequality.