Rude health I: Mary Harney must go
Here is my first column in Punt magazine:Mary Harney is a politician without a party, a minister without a mandate. She has been in government for 13 years, the Minister for Health for nearly six years. Despite the demise of the PDs, their ideology prevails. The Minister does not understand that free market economics does not apply to running a health service.
She has over seen the most ‘radical’ reform of the Irish health system since 1970 with the foundation of the HSE. Yet, despite endless restructuring, she has failed to really reform the Irish health system – to provide universal health care where access is based on need, not ability to pay. Universal health care is the norm in all other European countries. Not here. Uniquely in Ireland, one can skip the queue into public hospitals, if you can afford to pay privately or have private health insurance.
Despite a decade of so called reform, a quadrupling of the health budget, a 61% increase in health staffing, this government has failed to provide an even playing field for all Irish citizens when it comes to getting healthcare.
One of her many self-proclaimed achievements was the agreement of a new consultants contract which took four and a half years to negotiate. This same contract pays Irish consultants two to three times the salaries that are paid in England or Sweden. It further institutionalises the two tier mix of Irish healthcare by allowing 70% of consultants to treat public and private patients in public hospitals. In no other European country is private work allowed and incentivised in public hospitals. Ireland is alone in the systemic inequalities the state perpetuates within the health system.
This minister stated recently that she is ‘a real fan of co-payments’. Mary Harney thinks charging poor, sick patients a small fee for prescription drugs is a good thing. All the international evidence is conclusive – that co-payments, no matter how small, put people off using essential, sometimes life saving medicine.
Minister Harney has some achievements in her tenure – the centralising of cancer services to eight hospitals is a hard won victory which should result in better quality cancer diagnosis and treatment for Irish citizens. Yet it does not make sense to have no cancer centre north of Dublin or Galway. And while real progress has been made enhancing and centralising cancer services in the public system, other government policy has given tax breaks to developers to build private hospitals any where they choose. Many of these new private hospitals are carrying out cancer treatment. Try square that circle..
Under Harney’s time in health, there has been increased investment in services for people with disabilities and older people. However many of these services were so under resourced that the much needed funding was just a start to having twenty first century services for some of our most vulnerable people. Also many services remain ‘inhumane’, such as our psychiatric hospitals, the skeleton services that exist for children and families at risk, the poor quality of stroke care and rehabilitation services.
Mary Harney is the wrong woman in the wrong job. All opposition parties are now in favour of a universal health service. So are the Greens, even Fianna Fail could be wooed onside, but as long as Harney is in post, our inimitable, unequal system will persist.