Sinn Féin - On Your Side

Health Minister should resign his position over health crisis

2 March, 2004


Speaking during the Sinn Féin Private Members Business debate on Health care delivery Sinn Féin Dáil leader Caoimhghin Ó Caoláin said, "The government will argue in this debate that they have devoted unprecedented resources to health. And so they have. But this has come after decades of underfunding. At the same time the Government's refusal to challenge the two-tier system means vast amounts of public money continues to subsidise the private healthcare business to the detriment of public patients.

"In 2002 Fianna Fáil made a commitment to the electorate to "permanently end waiting lists in our hospitals within two years". That promise becomes due on May 17th next. But there are still over 27,000 people on hospital waiting lists.

"There can be no confidence in a Minister and a Government with such a record on health, not only since 2002 but since 1997. This was their principal mandate from the p model defended by Minister O'Hanlon in 1991 and by all his predecessors and successors has been maintained. This is the Government's preferred model for healthcare delivery in the 21st century. The core of the motion before you is the rejection of that model, the identification of many of the inefficiencies and inequities that flow from it, and the presentation of a radical alternative.

The government will argue in this debate that they have devoted unprecedented resources to health. And so they have. But this has come after decades of underfunding and because of this Government's refusal to challenge the two-tier system vast amounts of public money continue to subsidise the private healthcare business. Meanwhile public patients suffer.

In 2002 Fianna Fáil made a commitment to the people to "permanently end waiting lists in our hospitals within two years". That promise becomes due on May 17th next. But there are over 27,000 people on hospital waiting lists and as the Minister stated in his reply to my Dáil Question last week, this is a decrease of only 7% since 2002. That's 93% short of what the people were promised. If that rate of decrease were maintained it would take more than 14 years to end waiting lists.

The lack of coherence in Government policy is shown by the Treatment Purchase Fund. This was supposed to be a temporary measure yet now the government relies on it as its primary means of addressing waiting lists. It is a perfect illustration of the inefficiency that this government is funding. While beds in public hospitals remain closed due to lack of resources in the public system, treatment is being purchased in the private system. It is a short-term fix while the need to increase bed numbers and staffing levels in the public system is neglected. It is the patients of the future who will suffer as our public health infrastructure is allowed to wither.

The National Economic and Social Forum Report 'Equity of Access to Hospital Care' states that structural change is necessary to address the two-tier public/private system in hospital care and, most significantly, it states that this system is left unchanged in the Government's Health Strategy. Yet in its amendment to this motion the Government relies on that strategy to deliver equity of access.

The failure to renegotiate the consultants' contract and to require all new consultants to work exclusively in the public system is, in many ways the key to all the other failures in health of this Government. It is above all a failure of political will to challenge vested interests and to put the public patient first. I am not advocating a policy of confrontation. But I am asserting that fairness and equity must be at the heart of the system. The privileged position of consultants, their undue power in determining policy, their lack of accountability for work in the public system while profiting from private practice are all inherently unfair and inequitable.

The Minister has described consultants as "kings in their own domain". He has been thwarted by them on many occasions, for example in the disgraceful delay in proceeding with the investigation of difficulties between consultants in Cavan Hospital. More seriously, the victims of malpractice in the Obstetrics and Gynaecology Unit at Our Lady of Lourdes Hospital, Drogheda, have been disgracefully treated directly as a result of the lack of accountability of the professional bodies. But what has the Minister done to challenge this? Precious little.

The Minister's party also promised "to extend medical card eligibility to over 200,000 extra people, with a clear priority being given to families with children". In their 2002 Programme for Government Fianna Fáil and the PDs promised to "extend medical card eligibility in line with the recommendations of the National Health Strategy". The Strategy promises to increase medical card income guidelines. Once again there has been zero delivery and low income families with children who do not qualify for the medical card are now worse off than they were two years ago.

The failure to extend medical card qualification and the failure to develop Primary Care as promised makes the closure of services in local hospitals even more grievous. Look at how communities have united in defence of these hospitals. Listen to their voices as you have failed to listen in the past. The Hanly report is a recipe for the closure of more services and quite possibly hoswealthy in our society will be required to contribute more in taxation than they do at present. All taxpayers should be guaranteed that the best use is being made of their money. That is not the case at present. Instead we are funding inequity and its twin - inefficiency.

It must be acknowledged that progress has been made in recent years and tribute should be paid to all those people throughout the health services who have contributed to progress. For a transformed health service we need to harness their talents and their dedication. But they need leadership with vision and a strategy based on equality. This Government has given them neither and has broken its commitments to the people.

There can be no confidence in a Minister and a Government with such a record on health, not only since 2002 but since 1997. This was their principal mandate from the people. They have failed and the Minister should go.

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