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Sláinte Care

Is it Past time for us to shout ‘STOP’?

Are we too late shouting ‘STOP’ to what is going on in our health services? We are constantly being reminded of the mess the services are in and if it is not Trolley figures or Waiting lists numbers being exposed by national and local radio and press in general we are hearing local stories that are horrific and in the words of our leaders – ‘unacceptable’. For nearly two decades now Taoiseach after Taoiseach, Minister for Health after Minister for Health, TD after TD has used the term – unacceptable - and I have used the term but we all continue to ‘accept’ it. Surely it is time for us to stand up and say – ‘enough is enough’.

At the moment they can tell us that the Sláinte Care report is on the table and will bring great reform and sort out all the problems – bunkum. It will never happen as planned but snippets of it will be implemented and that will just shift the problem from one area of the Health Services to another and patients will continue to suffer and die needlessly. This report was presented last year and the Taoiseach was to appoint the people to implement it and that was to happen in July 2017!!!??? That has not even been done. But there are bigger questions about this report, which remove any confidence I might have that it will achieve change.

The report tells us that we will have ‘a universal single-tier health and social care system where everyone has equitable access to services based on need and not ability to pay. Over time, everyone will have entitlement to a comprehensive range of primary, acute and social care services at no cost or reduced cost. The vast majority of care will be provided in the primary and community settings’.  Unless there are serious and major changes to the way things are done, this will never happen. There are too many vested interests and the Private sector of the Health provision will not sit back and see this happen. They tell us they want to shift care out of the hospitals into primary and community settings yet at the same time they want to ‘expand hospital capacity and the phased elimination of private care in public hospitals. Is it not a contradiction to remove services from hospitals and yet expand the hospital capacity??

The report does put a strong emphasis on addressing the recruitment and retention problems currently plaguing the system. The resolution of these problems will be complex and take time and money but essential if any other reforms are hoped for. They are hoping for ‘a guarantee of 12 weeks wait for inpatient procedures and 10 weeks for an outpatient appointment’ – why have to wait three months if so much is being removed from hospitals and why have a 10 week wait for an appointment? They are certainly not going to challenge this big problem for patients with those expectations.

The report recommends the elimination of private care in public hospitals but also recommends that an impact analysis be carried out to ascertain what impact this will have on the public system. It is clear that when public hospitals cannot access the huge money they make from treating private patients at the moment we must ask where will that funding come from then – the taxpayer no doubt.

‘The HSE in future will become a more strategic “national centre” carrying out national level functions and regional bodies will be established to ensure timely access to integrated care, with regional health resource allocation’ – so states the report. What?? Are we going back to the Health Board system that we found did not work? The regional bodies will be nothing more than the old Health Boards back in action. I can also see what would happen here if this were to be introduced – all those working for the HSE at the moment would retain their jobs, with no work to do, and new personnel would be taken on to do the regional work and so the quangoes increase again and more pen pushers and massive salary costs for the taxpayer to pay. A new office , The Sláinte Implementation Office, would also be set up to oversee the implementation of the plan and to ’develop an implementation plan for the reform’!!!! So now another quango will be set up to come up with another report and a plan for the plan!! And they will have to get offices and office staff and equipment and water and heat and Iphones and Ipads and good salaries and all that goes along with a new office set up and be given time, no doubt ten years or so, to come up with the plan for the plan!! I ask - have we not got the personnel and the ability from within the Department of Health and HSE to get the people to do this work. Surely some from Department and HSE could be appointed to get this plan going as part of their jobs?

The report claims that - the Committee has worked tirelessly in its consideration of the national and international evidence, through public hearings, facilitated workshops and in-depth consideration of the evidence’. I ask – did any of you see or hear of or was invited to attend any public hearing, workshops or meetings to give your opinion on this matter?

One very clear inkling of the expected failure of this report comes when they say -  ‘Inevitably, members hold different political views on how to achieve the shared goal of a universal single-tier health system. But all have worked respectfully and collegiately (sic) over many months to deliver this report’. Yes it has been very friendly and well-funded but now it becomes a political issue and it will be bandied about for point scoring and political expediency and sooner or later end up gathering dust on the shelves of the Minister’s office. Towards the end of the report we are told that ‘they have not factored in the savings that would be made’ and that is so laughable when one sees the enormous money needed to put the plan in place and they talk about ‘saving money’. Oh yes, we waste our breadth.