What are the Greens up to?

Posted in Blog by saraburke on October 9, 2009

As the Green party team are deep in negotiation with Fianna Fáil over a new Programme for Government, one of their policy demands is a one tiered universal health system. What on earth are they at?

The policy demand of a one tiered universal health system was part of the leaked ‘early draft of a discussion document’ to the media. They are v cross about the leak. The Green party are refusing to comment on any content of the negotiations, as they don’t want to discuss deliberations in public. But they are not denying that it is in there either and referred me back to their health policy document. So what are the implications of this demand?

The Green Party manifesto and health policy in the run up to the 2007 general election had two specific commitments in relation to universal access. They committed to

  • “introduce free primary health care for children under the age of six in their first term in office, extend to all under 18s in the following term with free primary care for all by 2017”
  • “phase in Social Health Insurance over a period of ten years”.

“Ultimately the Green Party supports a system of Universal Health Insurance, to ensure universal health coverage for all”. We are as far away from that now as we were then.

So what’s so unusual about this demand if it is their health policy?

What is so interesting about it is that it is so completely contrary to current government policy of which they have been a partner for 2 ½ years.We are so far away from universal one tiered health system and if anything this has been further exacerbated by the current government. We have           

  • Two tier public hospital care which privileges private patients over public
  • 70% of patients pay out of pocket to see a GP, pay for their own drugs and range of other ancillary services
  • Mary Harney proudly undid the only aspect of universal care by taking medical cards off 20,000 people over 70 years of age.

So why on earth are the Greens looking for this? We can but speculate…

I revisited the 2007 manifestos of the Green party and Fianna Fail and compared these to the agreed Programme for Government from 2007.

The 2007 Programme for Government included

  • Personal health check
  • €2.1 billion in primary care facilities – €2.4 billion in building hospitals
  • Increase public only hospital beds by 1500 – significantly fewer beds now
  • Co-location – review of HSE structure – has not happened
  • Doubling no of consultants to 4,000 – try doing that with new salaries!

What is clear is that in health anyway, the Programme for Government was virtually a cut in paste of the FF manifesto, with a few PD additions and not worth the paper it is written on.

So why are they doing it?

  • To sabotage the negotiations – probably not
  • Because Greens are in a stronger position now than they were in 2007 – perhaps. Previously, smaller parties in negotiations with Fianna Fáil have talked about how Fianna Fail want power and the smaller parties want policies, so maybe the Greens are playing this game. One senior party source talked about FF as “very malleable”
  • Because as they say they want to “agree a transformational plan to get Ireland back on track & to make the best use of limited State resources”.

Is the Greens demand for a universal health system with Mary Harney’s ministry in health?

In my opinion, not at all. However, if you ask Mary Harney as Sean O’Rourke did last Saturday during the referendum coverage, she thinks so. I put this to her on Monday and she accepts that we do not have a one tier universal access

Mary Harney acknowledged that we all want to have universal access – which was an extraordinary statement to me given that it is very far from official policy and action in the health services which maintains the two tier access to hospital and primary care. The new consultants contract instead of getting rid of two tier access reinforces it as 2/3s of consultants are allowed to practise privately. Well over 20% of public inpatients care in public hospitals is private care.

So where does this leave the Fianna Fail/Green negotiations in relation to health?  Sara: There are a few scenarios.

  • When I asked Harney about this on Monday she started talking about the Resource Allocation working group that is chaired by Frances Ruane Director of the ESRI, and is due to report next April/May. The Recourse Allocation Groups is primarily focused on make suggestions on how best to allocate resources but also has the scope about making suggestions on how best to provide resources. SO they could agree to kick this issue to touch til next April or May when this group is due to report.
  • Or they could walk over it but I assume if the Greens are going to walk they will walk over the priority issues for the Green party membership, like electoral reform, reversal of education cuts, environmental issues.
  • Or it could be more of a political outcome than a policy one, that in order to continue in government, there needs to be a new minister of health who is willing to introduce a one tier universal health system.

So if the Greens don’t go, then Harney could go, as I just do not see who the two positions are compatible.

And there is a particular poignancy in the timing of the Green convention this weekend as it coincides with the second anniversary of the death of Susie Long.

Susie Long spoke publicly on Liveline about her delayed diagnosis as a public patient. And despite a common waiting list for diagnosis introduced since then, we know that public patients in some cases still have to wait longer for diagnosis and treatment than private patients. Only when there is a government commitment for a one tiered universal health system will we really able to get rid of such inequalities…

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