This Government has reneged on its pledge to sort out hospitals
Opinion from the Irish Independent on 30 November 2015
Enda Kenny ran for election in 2007 pledging to “end the scandal of patients on trolleys”. By 2011, he was even more ambitious, promising that “the two-tier system of unequal access to hospital care will end”.The Taoiseach is correct in wanting to put an end to these two appalling aspects of our health system. It is wrong that each month there are on average about 7,000 people on hospital trolleys. It is inexcusable that we remain one of the only high-income democracies that deny timely access to diagnosis and hospital treatment on the basis of inability to pay.
Decades of persistent overcrowding in emergency departments and extremely long waits for basic tests and hospital care are not normal anywhere else in Europe. They should not be here.
Yet eight years on from pledging to end patients on trolleys and five years on from the promise of universal healthcare, these problems as are bad now as they were when Kenny became Taoiseach.
According to Róisín Shortall, a junior health minister for the first 18 months of this Government, by summer 2011 it was perfectly obvious that Fine Gael and James Reilly’s plans to deliver universal health insurance through competing private health insurance companies was a non-runner.
A year and-a-half ago, the Government eventually published a White Paper on universal health insurance, which promised universal access to healthcare at no extra cost.
Then the Taoiseach insisted that real reform only happens during times of crisis and that their universal health insurance plan was “value for money”.
After the long-awaited publication of costings on the Government’s universal health insurance model, Health Minister Leo Varadkar finally conceded that it was not “affordable now, nor ever”.
It is pure negligence that other options for delivering universal healthcare were not considered by Fine Gael during their long time in opposition or even in the early stages of this Government.
But it is not just James Reilly and Enda Kenny who are to blame, this was a government-wide policy in which all members of Government, senior civil servants and political advisors colluded.
Even now, the Taoiseach insists: “The Government remains committed to the ending of a two-tier health system… paid for by universal insurance, but on a more affordable basis.”
But once again, no detail on how or by when, just more useless words.
Very inconveniently for Government, the number of patients on trolleys remains persistently high throughout 2015. It is higher than last year, which was much worse than the year before.
As Health Minister, Mr Varadkar has prioritised dealing with overcrowded emergency departments. He is on the record as saying that trolleys should not be the norm, that there should be zero tolerance for anyone being on a trolley for more than 24 hours.
Yet year on year, there was little change in the number of patients admitted or discharged within nine hours. Between January and September of this year, a total of 3,688 patients waited more than 24 hours in emergency departments and 864 of these were aged 75 years or over.
Now, to make matters worse, INMO nurses in emergency departments are threatening strike action in the weeks before Christmas, citing their intolerable working conditions as the their reason for action.
However, as everyone now agrees, most of the solutions for emergency department overcrowding lie outside of them: in primary care; in increased and better community and social care; in opening up more doors in and out of hospital; in changed work practices.
The Emergency Department Task Force Group set up by Mr Varadkar is trying to address the myriad of factors that cause overcrowded emergency departments.
INMO secretary general Liam Doran is co-chair of this group. Surely he too understands that ending the high number of patients on trolleys requires more than just additional hospital nurses and additional hospital beds?
Nurses should not have to face the conditions that they do every day.
But they also need to be part of the solution, working different rosters so that there are more of them on duty when there are more patients in emergency departments – a pattern which is utterly predictable. Nurses need to be working across their hospital and the community to get patients in and out of hospital as quickly as possible.
The timing of their proposed strike action is purposeful. In the run-up to Christmas and an election, it will be hard for the Government not to bend over to their demands.
But their intent of getting rid of the intolerable conditions might backfire if the strike results in actions solely related to emergency departments.
Having weathered a tough term in government, Fine Gael is doing well in the polls and is now in the process of developing an ‘ambitious manifesto’ for the next election.
But how can anyone believe any of it, given the party’s lack of credibility on trolleys and universal health insurance?
Opinion polls show that health is top of people’s concerns; it is, after all, a matter of life and death.
Enda Kenny has one last pre-election chance to rid our hospitals of trolleys through solutions across the health system.
It is in every Irish citizen’s interest that he does so.
And maybe even his own.