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Government has reinforced two tier health system – Ó Caoláin

30 April, 2009 - by Caoimhghín Ó Caoláin TD

Speaking in the Dáil today on the Health (Miscellaneous Provisions) Bill 2009 Sinn Féin Health Spokesperson Caoimhghín Ó Caoláin TD criticised the Government for presiding over and reinforcing "a system where wealth can buy speedier access to healthcare and where the private for-profit health business is allowed to act as a parasite on the public health system."

Deputy Ó Caoláin said:

"This is the not the Health Bill we should have before the Dáil today. On 1 April the Minister for Health & Children announced the establishment of an Expert Group on Resource Allocation and Financing the Health Sector. It is not due to report until April 2010. I have no doubt that the deliberations of the new group will be used to further delay the publication of the Eligibility for Health and Personal Social Services Bill which has been promised for years.

"Why the delay? The answer is obvious. The last thing this Minister for Health & Children and this Government want to discuss is the question of rights and entitlements to health services. They have presided over and reinforced a system where wealth can buy speedier access to healthcare and where the private for-profit health business is allowed to act as a parasite on the public health system.

"As the public health system reels under the cuts imposed since 2007, and braces itself for even worse to come, the Minister ploughs on with the building of private for-profit hospitals on public hospital sites, subsidised by the hard-pressed taxpayer.

"The Minister and the Government impose a so-called public service pension levy on nurses and they sanction the non-renewal of contracts for up to 14,000 workers in the public health service. At the same time the Minister gives a gold-plated guarantee to the hospital consultants that their €250,000 per annum contract will not be touched. This is for a 33-hour week in the public system and they can still work up to 25% of the time in private practice. And, even at that, the hours are not properly monitored, providing another lucrative let-off for those, whatever their number, who are happy to abuse their privileged position.

"This is what the Minister and the Department of Health & Children preside over in the crumbling Hawkins House, the ugliest building in this city and a suitable symbol of Government health policy.

"What is the role of the legislator in all of this? We are excluded, except for the rubber-stamp type of legislation that we have before us today, the Health (Miscellaneous Provisions) Bill 2009. The Minister has made herself unaccountable through the establishment of the HSE while major policy decisions with huge implications for the health service are not put before the Oireachtas. For example, the Government never put one sentence of substantive legislation before us regarding co-location.

"This Bill gives more functions to the HSE and to the Department. It is something I am reluctant to do. Earlier this month in my constituency two prominent GPs resigned from the HSE GP Unit, citing in an Open Letter to Professor Brendan Drumm, the arrogance of HSE management and their disregard for the views of GPs. In February 41 GPs in Cavan and Monaghan signed another open letter opposing, on patient safety grounds, the removal of acute medical services from Monaghan General Hospital.

"However, we have no choice but to address this Bill within its limited scope and to accept in good faith the assurances we have been given that the functions of the various bodies now to be subsumed into the Department and the HSE will be properly fulfilled. But we must also be assured that the work will be properly monitored and that the Minister and the HSE will be fully accountable for these functions.

"The Bill dissolves the National Council on Ageing and Older People and transfers its employees, assets and liabilities to the Department of Health & Children. It establishes the Office for Older People to support the Minister of State for Older People.

"The Programme for Government has a commitment to frame and publish a National Positive Ageing Strategy and the Department has informed me that this will now be its function.

"A cross-departmental group has been set up to prepare the Strategy and former Minister of State Hoctor has said that it is intended to facilitate the participation of older people in the process of preparing the Strategy. These include an invitation to make written submissions and the conduct of consultation meetings around the country.

"I urge that this work goes ahead and without delay.

"I also urge that the Government reverse its recent decision and proceed with the publication of the National Carers Strategy, a matter of vital concern to older people.

"The production and implementation of these strategies will be the real test of whether the Office of Older People will work.

"With regard to the dissolution of the

National Council on Ageing and Older People, the Women’s Health Council, the National Cancer Screening Service Board, the Drug Treatment Centre Board and the Crisis Pregnancy Agency, concern has been expressed about whether their functions will be safeguarded within the Department and the HSE.

"I want to refer to the very relevant questions posed by the National Women’s Council of Ireland and I ask the Minister to respond in detail.

"Since the Bill does not provide for any review mechanism to monitor or measure this change of policy direction against outcomes how will Government and the Oireachtas know if the functions of the agencies are being carried out by the Department of Health and Children?

"What is the estimated cost of dissolving these bodies and what are the projected savings?

"What is being done to safeguard the knowledge or institutional memory, built up by these agencies since their inception? The staff in question have much knowledge and experience which should not be lost to the public service.

"What commitments have been made to ensure that the Department and the HSE will continue to work in partnership with civil society and other relevant sectors?

"These questions are especially relevant to the Crisis Pregnancy Agency. Its establishment in 2001 was a recognition of the need to address crisis pregnancy in a comprehensive and effective way. It has made progress and has helped to improve support for women facing crisis pregnancy. Since the inception of the Agency counselling services for women in this area have expanded significantly. The Agency has also played a role in helping to prevent vulnerable women ending up in the hands of rogue pregnancy agencies.

"That said, the need for the work of the Agency is as great as ever. Crisis pregnancy is still a major problem.

"So what has changed to warrant dissolving the Agency?

"This gets to the kernel of the Bill.

"Is all of this really about enhancing efficiency and co-ordination or is it simply a money-saving exercise?

"Time will tell, but we also need to know that mechanisms are in place to monitor the effectiveness of the work formerly carried out by these agencies and now to be carried out by the Department and the HSE.

"On other provisions in the Bill I welcome the amendment of the Hepatitis C compensation scheme to remove age limits for travel insurance.

"The National Cancer Screening Service Board is also to be dissolved and its functions subsumed within the HSE. It becomes part of the HSE’s Cancer Control Programme. The Bill provides for the National Cancer Registry Board to be appointed by the Minister. Yet it is also to be subsumed into the Cancer Control Programme in 2010. Will this be an interim Board, pending the change in 2010? If so what is its function?

"I hope the Minister or Minister of State will address the questions I have raised during the course of this contribution.

"Go raibh maith agat." ENDS

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