The opportunity to make real progress in meeting our needs was missed
Published 12/10/2016 | 02:30
We know that increased spending on healthcare is top of all the things Irish citizens wanted from Budget 2017, way ahead of tax cuts, a first-time buyers' grant or increasing the pension. Interestingly, Fine Gael voters, wealthy people and those over 50 wanted most spending on healthcare.
In the first Budget of this minority Government, health got €497m in extra spending. The HSE was allocated an additional €500m earlier in 2016 on top of last year's budget allocation but that was to try to ensure that no supplementary budget was needed as they are no longer allowed under EU fiscal rules.
Latest figures show the HSE is just under €6m in deficit. Yet with €497m of extra money allocated to health, it is safe to say that the health service is still under-funded by between €300m and €400m when it comes to meeting the extensive unmet needs of our growing population.
Providing quality healthcare and social services is mostly about care, yet staffing numbers are well below 2008 levels despite a growth in the population of more than 350,000 people - many of whom are very old or very young.
There was a commitment to more nurses in yesterday's Budget, but even with 1,000 new nurses in place next year, nursing levels will be at least 1,350 short of what they were in 2008. There is virtually no new money in Budget 2017 for much-needed service developments or investment to improve the quality of services and keep them safe.
There were lots of re-announcements of promises such as the new children's hospital, maternity hospital and forensic mental health facility.
Another measure re-announced yesterday was the extension of medical cards to all children in receipt of the Domiciliary Care Allowance, under which 10,000 more children will be covered.
This move was a no-brainer, which every party flagged as a priority in the run-up to the spring election.
Figures from the Irish Longitudinal Study on Ageing (TILDA) show that cutting prescription charges for over-70-year-olds from €25 to €20 will save about 10pc of over-70s between €2.50 and a fiver a month. This means it is irrelevant to 90pc of people over 70.
It does nothing to alleviate the pressure on anyone under 70 with medical cards and the 64pc of the population without medical cards who have to pay up to €144 per month for essential medication. The 2016 Programme for Government promised to "significantly reduce the cost of medicines".
Meanwhile, €15m has been allocated to the National Treatment Purchase Fund (NTPF). This was announced by Simon Harris in July in an effort to reduce waiting lists for public hospital treatment, which are at their highest-ever levels.
This money should take thousands of people off the hazardous public hospital waiting lists, a welcome development. However, over a decade of pouring hundreds of millions into the NTPF is proof it does not address the underlying causes of the long waits for public patients in the first place.
From a health perspective, there is nothing new in Budget 2017, virtually no actions to match the policy rhetoric of "enhancing primary care and the integration of primary and secondary care", as promised in the 2016 Programme for Government.
Paschal Donohoe and Mr Harris have missed an opportunity to undo some of the worst of the austerity measures in health and to improve the availability of public health services.
There are no "new directions" as claimed by Fianna Fáil, no "new politics" as heralded by Fine Gael. Instead, a range of small, meaningless measures that will do little to increase access to essential health and social care, not to mind deliver the modern health services that citizens have told the politicians that we really want.