Tuesday 17 October 2017

A blank cheque won't get HSE out of intensive care

'Beyond self-deprecating candour, his (Leo Varadkar) performance on hospital waiting lists amounted to another massaging of statistics by extending target categories from six months waiting times to 15 and 18 months'
'Beyond self-deprecating candour, his (Leo Varadkar) performance on hospital waiting lists amounted to another massaging of statistics by extending target categories from six months waiting times to 15 and 18 months'
Ivan Yates

Ivan Yates

The chickens are coming home to roost at the Department of Health. As reported in this paper earlier this week, the HSE requires €1.867bn to run the health service in 2016. This completely confirms how we've blown the economic crisis when it comes to reforming and modernising delivery of healthcare. We're back to square one. The slightest prospect of national budgetary flexibility is sufficient for a bloated HSE bureaucracy to revert to their singular clamour "give us more money". Because mandarins in Hawkins House don't know what they want, how to achieve it or where they're going, taxpayers must pour all the fruits of economic recovery into this bottomless pit.

After more than four years, the Taoiseach's singular top line agenda of "jobs", and his superficial, simplistic approach to government, results in a shambolic state of public health administration. Through austerity, we hacked €2.5bn off the health budget and paid dearly to voluntarily early-retire 10,000 personnel. We embarked on an un-costed, poorly researched, half-baked journey toward some notional Dutch system of Universal Health Insurance and populist promises of free primary health care for all. This FG misadventure, fathered by Dr James Reilly and signed off by Mr Kenny, came without a full examination of the consequences for 100,000 health workers' employment status. There was also the knock-on effects for the insurance premium liabilities on families, and the practical consequences for uninsurable services such as long-term residential care, mental health services or ambulance provision.

After Mr Reilly moved on, the UHI concept was disowned by the Department of Finance and prospective timetables abandoned; what exactly are we left with? A leaderless, rudderless and unaccountable health regime that doesn't know its end destination.

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