Republican News · Thursday 24 January 2002

Sinn Féin unveils radical plan for Health

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The 'big issue' in the forthcoming general election in the 26 Counties is not the Coalition mating game but the need for a radical alternative to a political establishment that has failed to harness new wealth to create real equality. Nowhere is this needed more than in the Health system, and last week Sinn Féin launched its ten-point plan and detailed discussion paper 'Health for All'. Endorsed by the 2001 Sinn Féin Ard Fheis, the plan proposes a National Health Service with free care for all funded from general taxation.

The 'Health for All' document was launched at a press conference in Dublin on 18 January. Dublin South West representative, Councillor Seán Crowe, pointed out that Sinn Féin has distributed 200,000 newsletters based on 'Health for All' to homes throughout the 26 Counties. He said this was an indication of the seriousness of the party about the health issue and of the level of commitment of the membership of Sinn Féin who do this work.

Caoimhghín Ó Caoláin TD called for "real debate about real issues" in the run up to the general election. Dublin South Central representative Aengus Ó Snodaigh analysed the FF/PD government's recently health strategy. We carry below the Sinn Féin health strategy as outlined by Caoimhghín Ó Caoláin and the critique of the government plan as delivered by Aengus Ó Snodaigh.

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"We want a real debate about real issues" - Ó Caoláin

Recent days and weeks have seen growing speculation about the outcome of the general election and the possible coalition partners who may emerge. We have seen detailed coverage of the mating game between the three larger parties. We have not been hearing what the vast majority of people want to hear and that is how all parties will address the major problems in our society. Foremost among these is the state of our Health System.

We in Sinn Féin want a real debate about real issues. The Irish people demand that their elected representatives act together to address their needs. The forthcoming election campaign, as far as we are concerned, will be about issues, and we will be putting our policies before the people and seeking their endorsement.

Sinn Féin's central demand on Health is for a health care system which is free at the point of delivery for all. This would include free GP care, free hospital care, free medication. This should be funded from general taxation. No more important use can be made of government revenue.

In this Discussion Paper we expand upon that basic demand which is the key and essential change needed to transform the health service. The inequalities that blight our health system persist because successive governments have maintained the two-tier public/private structure of the system.

It is a scandal that in our health system we have first-class and second-class patients. Private health care is subsidised by the State while those on public waiting lists get second-class treatment. In our hospitals consultants are being paid from the public purse for treating public patients while at the same time they profit from the thriving private health business. Their skills can be bought, and public waiting lists by-passed, at the right price.

No system built on that basis can be either fair or efficient. Successive governments have failed to grasp that nettle. The current's government's Health Strategy, despite the positive elements in it, continues that failure.

If transforming the health system and creating equality means taking on the vested interests of the most powerful minority in the health services - the consultants who benefit from both private and public systems - then it must be done.

Sinn Féin's ten-point plan of action for Health is:

• The creation of a new all-Ireland health system, free at the point of delivery and funded by general taxation;
• An increase in health care funding to the EU average of 8% of GDP, plus additional funding to help redress years of underfunding and cutbacks;
• The harnessing of all the health resources, facilities and skills on the island into a dynamic, island-wide health care system;
• The setting up of a single waiting list;
• Increasing the number of health workers, with special location allowances;
• Ending the public subsidising of private hospitals;
• A properly funded anti-poverty strategy to eradicate poverty and deprivation in Ireland, to be carried out within a specified time-frame;
• The prioritisation of health promotion and the inclusion of health-proofing of all public policies;
• Long-term planning and funding for hospital services;
• The involvement of local communities in developing health policy and strategy.

Sinn Féin will campaign during the forthcoming general election and beyond for the implementation of these health policies. We are committed to equality and efficiency in our health service because we are committed to an Ireland of equals.

"Government strategy fails to address 'flawed and inequitable' health care system" - Ó Snodaigh

It has taken this government over four and a half years to produce a document which outlines what has been obvious to us all for some considerable time. Our health system is in crisis. It is in crisis because successive governments made up of all the main parties have failed to invest in the health of our people.

There are some positive elements in the government's plans, such as the introduction of the 24-hour service and the creation of multi-disciplinary primary care "one stop shops". The formulation and implementation of a health care strategy with a wide consultation process in planning is also to be welcomed.

However, the bottom line is that there is little confidence that this ambitious plan will actually be implemented in the long term.

Waiting lists

The main problems in the government's strategy lie in the fact that it fails to guarantee long term funding. This in turn means that the reduction in waiting lists becomes aspirational rather than a concrete target that will be met. The failure to introduce a single waiting list also means that we will continue to have a 'flawed and inequitable' health care system as was stated by consultants from Harvard University last year.

Ending the two tier system

The Fianna Fáil/Progressive Democrat policy does not address the two-tier nature of the Irish health system. The public health service is still subsidising private beds in public hospitals. A report by Deloitte and Touche has found that though the private sector have 20% of the beds in public hospitals they only contribute 11% of the costs of running these hospitals.

Staffing the Health Service

A shortage of medical specialists is severely hampering the provision of public health care. From 1980 to 1999, the number of medical, dental and nursing staff have fallen from 33,700 to 32,500. We need to know how many new health care workers are being hired. We need to know where they will be working. We need to know how long newly hired staff will remain in the public sector.

Funding and Investing in Health care

The government's strategy of using private and public partnerships for building and investing in enhanced and improved health services raises many questions. Who will own, control and profit from these resources? There is a genuine fear amongst many people that these plans will represent an extension of the private sector into the public health system, where once again income not medical need will be the determinant of the speed and quality of treatment.

Regionalisation

A survey conducted by Trinity College academics in 2000 found that households in the wealthier parts of Dublin were three times more likely to find a GP in their neighbourhood than those living in socially and economically deprived areas.

The government's health strategy's proposal for new primary care centres will alleviate some of these inequities but there is a pressing need to roll out these new services in the areas of greatest social need as soon as possible.

A commitment for a real regional health care strategy that provides targets and guarantees is a necessity. People should not be forced to travel round trips of hundreds of miles and then face long delays waiting for a ten-minute consultation.

Accident and Emergency

Accident and Emergency services are a disgrace. Many people can testify to spending hours waiting even to be seen by a triage nurse before spending hours more waiting for consultation and finally medical treatment.

The service needs urgent attention. The health strategy overlooks the potential for creating dedicated emergency room facilities.

Pharmaceutical costs

There is little attention given in the government's health strategy document to the pharmacy costs borne by both the public hospital service and the GMS scheme. Pharmaceutical companies are among the most profitable businesses internationally.

The huge potential of health costs savings from either securing bulk discounts or instigating a policy of generic drug prescribing as against using the more expensive brand name drugs.

Fianna Fáil and the PDs have had almost five years and ample funds available to deliver on health. The National Health Strategy was their last chance to commit to the necessary reforms. But their plan will not end two-tier health care in this country. Fianna Fáil and the PDs cannot dodge this. They have failed us. I would assure Bertie Ahern and Health Minister Martin that voters will make their dissatisfaction about this government's record on health care known in the next general election.