Using health as a test case of junior ministers’ usefulness

See below for article on junior ministers from the Irish Independent on 22 July 2014.

The absence of any real achievement by the vast majority of junior ministers must call into question the very necessity of all junior ministerial posts. They have no power to make decisions or allocate money and are really just there to champion a specific aspect of a government department that is perceived to need public and political attention. Let’s use health as a test case of junior ministerial usefulness. 

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Health in a time of austerity

Here is my Medical Independent column from 29 August 2013. It is too early to say what effect the economic crisis is having on the nation’s health, despite recent claims in the BMJ.

Programme for Government health commitments, potentially ‘revolutionary’

The first sentence in the health section the new programme for government reads ‘this government is the first in the history of the State that is committed to developing a universal, single tier health services, which guarantees access to medical care based on need, not income’. The opening line of the full document refers to a ‘democratic revolution’ that took place on election day, how with the stroke of a pen the public had demanded change. 

No relief for sickest and poorest in Budget 2011

See here for my analysis of the budget implications for health published in today’s Irish Times, with a few of the bits they left out added back in! And my mega typo corrected…

LISTENING TO Brian Lenihan’s Budget speech, you’d think the health services were going to be untouched by austerity in the years ahead. Although health services make up 27 per cent of current spending, they are just under one-third of the €2.2 billion in cuts outlined, yet they did not even get a mention.

Multiple ministerial briefing on health budget 2011

If you are sad or enthusiastic enough to hear what the FOUR ministers in the Dept of Health had to say about the €727 million cut to the health budget, you can listen in here

Just out special issue of Irish Journal of Public Policy

See here or below for chapter I wrote on health in special issue of Irish Journal Public Policy: Boom to Bust, Irish Social Policy in Challenging Times. See here for links to all the other chapters.

Cuts put bite on dental schemes

Proposals to abolish public funding for treatment is now on the political agenda, writes SARA BURKE

THE FUTURE of all publicly funded dental schemes is in jeopardy in light of growing demand for the services and tightening budgetary circumstances.

The Department of Health and the Department of Social and Family Affairs have both prepared internal memoranda in the past two months on the implications of abolishing two publicly funded dental schemes.

The Renewed Programme for Government – little new on health….

The health section of the new Programme For Government has been called ‘all Fianna Fail’. But it is not all Fianna Fail, it’s all PD, with a few minor Green hints in it. It is PD health policy reflecting that we have had a PD minister for health for the last five years.

I presume the health section was written in its entirety by Oliver O’Conner who is Harney’s advisor in health. There are few new commitments in it, no costings, but there is no need for costings as there is little extra in it.

The leaked document by Irish Times’ Stephen Collins said the Greens were looking for a one tiered universal health system. And what did we get? The intro to the Renewed Programme for Government under health says “We will take further progressive, detailed steps towards building universal health services that provide high-quality care, fair access and affordability for all.” This is a far call from a commitment to introducing universal, one tiered, free care for all. More detail on the ‘Renewed Programme for Government’ here including colocation, cancer services, screening and vaccine, mental health and the Resource Allocation Working Group …

Proposed health cuts are the wrong way to go

Here is the article that appeared in Irish Times on 3 August. I am taking August off so this site will be quiet for the month. Will be back in September. Keep the comments coming and enjoy any sun we get!

THE McCARTHY report is comprehensive and provides an overview of the piecemeal nature of Irish policy-making, alongside unparalleled increases in Government spending which dominated the past 12 years.

However, the “menu” of cuts in the health sector is unsatisfactory and, in some instances, based on erroneous assumptions. This is significant because more than one-fifth of the €5.3 billion proposed budget cuts are in health. The top three health savings suggested are: reducing HSE staff by 6,000 (saving €300 million) plus efficiencies (€90 million); opening up contracts with GPs, opticians, pharmacists and dentists to tender and presumably negotiating better deals (€370 million); revising down income eligibility for medical cards (€100 million).

Speaking on the night of the publication of the report, Colm McCarthy said: “There is scope for economies in staffing throughout the health service, there have been enormous increases in staffing . . . Everyone knows the staffing ratios are now high by international standards in certain parts of the health service.”

Is McCarthy right?

An Bord Snip – An attack on the health of the nation

Below is post by me on progressive-economy blog.

The Bord Snip Nua report has the potential to undermine the health of the Irish people and specifically those who already have the poorest health.

Proposing a cut in social welfare rates of 5% shows no understanding of the day to day realities of living on €200 a week. Already the vast majority of the 1.2 million social welfare recipients have received a 2% cut in their annual income when their Christmas bonus was taken away from them in the April budget.

Over 90,000 people who receive rent supplement have also received a further cut through the changes introduced in the October and April budgets which mean they have to contribute about €11 more per week, which in effect is an 8% cut. Basic social welfare rates are already below the poverty line of €228 per week.

Does this government really want to push more people on social welfare further and deeper into poverty and poor health? It is well established that the most important contributory factor to poor health is one’s income, housing, education and work opportunities. Cutting social welfare rates will not just impact on people’s day to day lives and pockets, but also on their health.

The proposals for the health sector are also an attack on the public health service which has been built up over the last ten years. McCarthy et al outline €1.2 billion in cuts in the health area.