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Ó Caoláin - Health proposals do not represent real reform

27 June, 2003


Sinn Féin Dáil leader and spokesperson on Health, Caoimhghin Ó Caoláin, speaking during Statements on Audit of Health Structures, today accused the Government of embarking on administrative change rather than real reform. He said, "the two-tier health care system is inherently inefficient and no amount of better financial management or administrative restructuring can change that reality". He went on to say that the Governments proposals will mean less democratic accountability and that Sinn Féin would continue to campaign for a truly reformed health service.

Deputy Ó Caoláin said: "It is a tragedy and a scandal that healthcare in this State is delivered by means of a fundamentally flawed two-tier public-private

system. The Government's Health Strategy opted to retain this system. The two reports do not challenge it either, although they do expose some of the unfairness and inefficiency of the two-tier system. Health apartheid divides our society on income lines. The contribution to the common good which those on higher incomes could make is lost to the public system. As the Brennan Reports again exposes, many hospital consultants very profitably straddle the two systems and it is the public patient who loses out. The two-tier system is inherently inefficient and no amount of better financial management or administrative restructuring can change that reality.

"The vision and the political will to fundamentally reform that fundamentally unequal and inefficient system is absent from this Government.

"One of its key policy objectives and targets of the Health Strategy was for all additional beds to be designated solely for public patients. But instead of additional beds we are seeing bed closures, over 500 this year. At the same time public money is going to buy treatment in beds in the private system under the PDs' cherished Treatment Purchase Fund. This is a classic example of the piecemeal and contradictory approach of this and previous governments.

"The Government is embarking on administrative change rather than real reform. The most important recommendation of the Brennan Report is that all new public consultant appointments be on the basis of a commitment to work exclusively in the public sector. But the Government has chosen not to include that essential reform in its package of measures. We are urged to wait on the Hanley Report. But I suspect that the powerful consultants lobby has been at work and unless the government champions this proposal it will be shredded in negotiations with Finbarr Fitzpatrick and his colleagues.

"The administrative changes will mean less democratic accountability. Few will lament the passing of the existing health boards but where will the democratic input be? There is a reference in the Prospectus Report to Oireachtas representation at the level of the four Regional Health Offices but there is no detail and the Minister would not indicate in his response to my question on Tuesday what the composition of the Health Services executive will be.

"These reports come at a time of escalating government cuts. As beds are closed,as queues lengthen, as services for people with disabilities diminish, as people just above the income limit struggle to pay for GP visits, the Government will wave these reports at us and make more promises of a world class health service ? but not yet. It is not good enough and we will not stand for it. We in Sinn Féin will continue to campaign for a truly reformed health service which cherishes all of our people equally." ENDS

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