Solving the HSE Conundrum
Lest we continue to get distracted by polls and process, it is definitely noteworthy to point readers to the health policy announced today by Fine Gael. The policy, headlined as abolishing the HSE, reads like a step-by-step dismantling of the public-private divide to replace it with a system of private insurance and universal coverage, semi-private hospitals and money-following-the-patient. We have had the FG policy for some time, and those attending today suggested little has been added to the Dutch system epiphany today.
The policy is worth reading, for it suggests eliminating 8,000 jobs (as part of FG’s overall 30,000 target?) from the HSE and dismantling the behemoth by 2018/2019. Specifics and detail, well that is for next week.
According to Reilly:
“In 2001, Micheál Martin, then Minister for Health, announced his intention to end waiting lists by 2004. Both he and the HSE have spectacularly failed to meet this target.
“We recently witnessed 569 patients on trolleys in A&E and over 19,000 patients waiting more than three months for treatment.
“The message is simple; ‘Micheál Martin’s HSE is not working’. Fine Gael’s FairCare will completely reform the health system and is divided into three key phases:
Phase 1 (2011-14): Fine Gael will reform the current system to bring down waiting lists and build a stronger primary care system.
Phase 2 (2014): Fine Gael will change the way hospitals area paid. Block grants will be replaced by a system based on the numbers of patients they treat – ‘money follows the patient’. This will increase productivity by between 5% and 10%.
Phase 3: (2016): Fine Gael will begin the introduction of UHI. However, we know this is a long term project and bedding down all of reforms will take place during the following five years.
Well worth taking this into your electoral consideration – the HSE has claim to a huge amount of exchquer funding, in an era of cuts it is already in the firing line. FG assert you can lose 8,000 jobs and move to their system without affecting frontline services. As James Reilly is deputy-leader of Fine Gael, it seems a fair bet that the party will not allow the department to move to any coalition partner after the election. The proposal for the separation of “the purchaser of healthcare (the State) from the providers of healthcare (the hospitals)” implies the space for growth of private, for-profit hospitals.
For Labour, a universal health insurance system is underpinned by a public hospital systems drawing on public funds. We should naturally wait for the Labour health policy for full detail but as they have been on this since 2001, we are justified in not anticipating huge change. The ideological ground here is far tougher than on the economy. This is definitely something voters should be thinking about deeply prior to election day as there are plenty of non-economic social issues that need to be addressed in the post-tiger budget deficit era.