Gino Kenny (Dublin Mid West, People Before Profit Alliance) | Oireachtas source

Yes. The crisis in the health service is universally accepted as a fact, and with good reason. Waiting lists and trolley queues are not a seasonal aberration but a permanent fixture. The state of mental health service staffing, after ten years of A Vision for Change, is a national scandal. It is extraordinary that the Government’s acceptance of this crisis is still in doubt. The publication of the Revised Estimates for health shows that the Government, which has presided over the health crisis over the past five years, seems to be still stuck in denial.

During the past five years, the Fine Gael mantra was “more for less”. First James Reilly and then Deputy Leo Varadkar expected us to believe the cutbacks in health funding would do no harm. A child could have predicted this. Patient support groups and staff representatives told the Government about the devastating effects of austerity cuts on patient care. All of this advice fell on deaf ears. Less service for less funding would have been bad enough. However, Fine Gael wanted to introduce the market and the private, for-profit sector, which is its answer for everything, and we got even less service for more money. As a result of the additional €5 billion spent on health insurance and out-of-pocket expenses, Ireland has ended up with health spending that is above the EU average and quality that is below the EU average. We get less for more, not more for less.

Fine Gael and Fianna Fáil have misled the country about our health service and they continue to do so. All through its time in government, Fine Gael lectured the left on costing, insisting that the figures for alternative health proposals did not add up. Meanwhile, it never costed its flagship health policy of universal health insurance, UHI. Fine Gael introduced this UHI policy of private, for-profit health insurance in 2009 as FairCare. It announced it as policy in the Fine Gael 2011 election manifesto and the programme for Government. However, when it finally outlined the policy in a White Paper three years later, in 2014, it still had not costed it and could not say how much the health insurance would cost or what it would cover. I doubt Fine Gael has learnt a lesson from this.

The approximately €500 million increase in the health budget announced in the Revised Estimates is almost entirely consumed by the current real spending in health. This is not an overrun as the Government claims. In 2008, eight years ago, the health budget was the same, €13.6 billion, as it is today after the so-called additional money. Inflation in the same period was cumulatively more than 30% and the population is increasing in number and in age. This means there is less spending on health care than ever before. The smoke and mirrors of health funding continues. While the overall budget increases by just 6% year-on-year, the Minister has increased spending on consultancy fees in his Department by a whopping 96%.

Given the level of public concern and outcry about the neglect of mental health services, the Minister’s failure to address mental health is amazing. Staffing of mental health is only three quarters what it should be and only half the recommended level for children’s mental health services. Despite this, while the overall budget has increased by 6% the mental health budget has increased by only 2%. In the Revised Estimates, the €35 million noted as not yet allocated for new developments in mental health is described as additional funding. However, even when it is added in, the total is no more than the general increase in the health budget. The level of funding in mental health is only half what it should be, based on international comparisons, resulting in a deficit of €800 million.

While the announcement of developments in primary care, speech and language and psychology services is welcome and overdue, it is dismaying that no specific funding or staffing targets are addressed. While Fine Gael recently said it is committed to developing a one-tier, publicly funded health service, confidence is not inspired by the failure to be honest about deficits in capacity, staff, hospital beds and primary care centres. Continued talk of superficial fixes through buying and selling care in the National Treatment Purchase Fund and the setting up of hospital trusts can only lead public representatives, such as us, to conclude that Fine Gael, supported by Fianna Fáil, is still up to its old tricks. It is time for the Minister to stop running and spinning the numbers and address the staffing and funding crisis in the health service.

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