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Monday 29 May 2017

Future plans for a nation's health

People will continue to be sent to public hospitals where waiting times vary. Those waiting a long time for surgery can opt for National Treatment Purchase Fund. Hospitals to do more on day case basis with no overnight stay. Doctors to get plans to work "smarter" in order to treat more patients.

Fine Gael

Give hospitals targets. Weekly reports of progress to Minister for Health. If hospital has problems they will be analysed. By next decade entire country will have compulsory healthcare insurance. Premiums for 56pc paid in full by State or subsidised.

Labour

Compulsory universal healthcare insurance for all by 2016. Premiums for poorest paid by State, others subsidised. Higher income groups pay their own. People will have choice of private insurers. Will cost an extra €371m provided all hospitals operating at full efficiency.

Verdict

Decades of health manifestos are strewn with promises to tackle waiting lists and none ever live up to the hype.The Fianna Fail method is tried if not entirely trusted particularly by people needing a specialist. Fine Gael has produced no detail, budget or targets. Labour provided costings but figures may not stand up and hidden costs lurk. What will insurance premiums be? Will we be paying more taxes and how fast will access be under new scheme?

COST OF SEEING A DOCTOR



Fianna Fail

Continue with medical card scheme now covering 39pc of population, allowing free GP visits. Rest of population pay private fees, claiming tax relief. Seeing a specialist is free but can involve a wait stretching months in some hospitals.

Fine Gael

Will increase numbers with a GP card and begin phasing in free GP care for all, regardless of income, in 2016. In 2014 will start paying public hospitals per procedure -- unclear if this will include outpatient clinics. Between 2016 and next five years start rolling out compulsory universal healthcare insurance.

Labour

Free GP care for all by 2014. This year will extend medical card to those on Long Term Illness Scheme. This year public and private hospitals to begin tendering to provide diagnostic facilities for procedures. By 2016 compulsory universal healthcare insurance for all.

Verdict

The existing system of medical cards works well for those who have them but GP care can be unaffordable for those who lose out on income grounds. If a system of free GP care for all comes in tough negotiations with doctors are needed.They will have to submit to new contracts and forego private fees. And consultants are unlikely to welcome a €30,000 cut in salary each to fund free GP care. Fine Gael has not elaborated on how GP care is funded and many more doctors will be needed.

AVOIDING HOSPITAL



Fianna Fail

It wants to expand primary care centres outside hospital staffed by GPs and other professionals. People with long-term illnesses will increasingly be cared for in the community rather than hospital . Plans to increase primary care teams from 394 to 527 by the end of this year.

Fine Gael

More people to be treated in the community, particularly those with long-term illnesses. Has not produced any action plan or costings.

Labour

Expand primary care teams. There are 2,500 GPs working currently but up to 370 are needed to cater for roll out of free care to all. Plans to hire more practice nurses to take on a lot of the extra workload.

Verdict

All agree with need to shift more care out of hospitals. Progress has been made but is slow and pressure continues to pile on hospitals. Finding enough GPs is likely to be a big hurdle and the recruitment embargo has affected availability of key staff such as public health nurses.

In sickness and in health

Eilish O'Regan analyses the parties' plans to see what is on offer in three key areas

Voters interested in what the parties will do for mental health services, people with a disability and children in state care will not be surprised they have been pushed to the back of the queue again.

Except for Fianna Fail, which has access to targets in the HSE action plan for 2011, there is almost no mention of the so called Cinderella issues -- so far.

The emphasis has been on populist issues designed to woo votes. Will Fine Gael and Labour start means testing people getting home care packages? The Government's four-year plan points to the need for these free services to be examined and it may be impossible for the new Government to avoid.

What are the targets among opposition parties for transfer of people from psychiatric hospitals? There has been no mention of strategies or funding to tackle suicide.

And the needs of children in care received a short reference at the FF man- ifesto launch. But so far the other parties are avoiding any promises about extra social workers.

Irish Independent

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