Maeve Dineen: Stirrings of long-overdue revolution in health sector
An interesting thing happened in Kerry last week -- two GPs put an ad in the 'Killarney Advertiser' offering an ordinary consultation at €40 for adults and just €25 for children.
This simple story caught my eye for two reasons -- it is one of the first signs that the medical industry is finally embracing change and also of how the troika's attempts to restructure the economy will eventually make Ireland a much better place to live.
Health plays an enormous role in society -- and also in the economy. It accounts for more than one in every four euro spent by the Government and it employs a significant part of the workforce. Inflation in the sector is out of control as we saw from the latest VHI hikes last week.
We are already seeing significant numbers of people travelling overseas for relatively simple operations, such as dentistry -- and that trend is likely to gain momentum in the years ahead as people opt out of private medical insurance.
Almost every sector of society is now subject to audits and quality control checks, bar the medical profession, which is largely self-regulating. It is only in the past few weeks that GPs have become subject to random inspections. It speaks volumes about the profession that they have been able to resist such common-place checks.
What happened in Killarney is only the opening salvo in a battle that will blow the health industry wide open and create many opportunities for business people and companies.
Many of our leaders, including two cabinet ministers, have medical backgrounds so it is perhaps lucky that the troika is eager to deregulate as well. As we know at this stage, what the troika wants, it usually gets.
It is not too difficult to peer into the future, because most other European countries have already deregulated.
The doctors in Killarney offer consultations on a Saturday. Expect to see much more of this kind of thing in future. At the moment, expensive equipment is left unused for most of the night because consultants refuse to do nightshifts. Lack of competition means that we still have a nine-to-five system for routine operations when MRI scanners and the like should be operating round the clock. This has to change, just as many other businesses have had to adapt.
Hospitals will have to get used to league tables similar to what schools have today. Doctors will squeal, but expect to see lists of the top 100 surgeons or radiologists in the future. These are common overseas and allow customers to decide whether the extraordinary fees demanded by some doctors really are justified.
It will also create a super league of really well-paid doctors followed by a large pool of reasonably paid doctors. At present, we have a system where salaries cluster around the middle, and bad doctors can earn very well while excellent doctors are not paid enough.
These trends are evident in almost every other field of commercial life but have yet to make much headway in medicine, which has been protected by powerful interests as well as a fear of change common all over the world. Expect to see many dire warnings about medical Armageddon as health ministers -- with the troika prodding from behind -- introduce change. We must ignore the lobbyists who exploit our dark fears and embrace change. The starting position should be that the existing system has failed.
The fact that many people are cancelling their private health insurance will force hundreds of thousands of demanding patients into the public system and I suspect that they will begin to demand proper treatment.
That, coupled with the troika's demand that its money be spent more effectively, makes me optimistic that we are going to see a vast improvement in the quality and cost of medical treatment in the years ahead. What happened in Killarney marks the opening stages of a long-overdue revolution.
Irish Independent
