Sunday 21 December 2014

Letters: Doctors' income cuts to stall progress on free GP care

Published 07/08/2014 | 02:30

Leo Varadkar,TD,the Minister for Transport,Tourism and Sport  at Leinster House yesterday.Pic Tom Burke 9/7/2014
Health Minister Leo Varadkar pictured at Leinster House. Photo: Tom Burke

GPs nationally welcome Leo Varadkar's plans to defer Universal Health Insurance. As talks about it progress it is appearing more and more like the US healthcare system, where up to 30pc of all healthcare costs are swallowed up by insurance companies in administration costs, legal fees and profit-taking - with no regard to the cost-effectiveness of the service.

However, I am surprised that the new minister considers free GP care an option in the near future. He is obviously not aware of the current problems caused by the advantage taken of the Financial Emergency Measures in the Public Interest (FEMPI) Act by his two predecessors.

Between 2002 and the 2013 FEMPI/Haddington Road reduction, the average state funding per HSE employee had risen by 50pc due to increments for time in service, grade inflation and extraordinarily generous pensions; the consumer price index has increased by 24pc, but the payments to general practice per General Medical Service patient were lower in 2013 than they were in 2002.

The FEMPI Act resulted in a further €34m taken out of general practice. The recently-published OECD earnings data for Irish GPs indicate that had the Haddington Road cuts been applied fairly to general practice, less than €5m would have been taken. Massive underfunding of the most cost-effective element of the health service, in association with the culture of prioritising of political and bureaucratic gains over patient-centred outcomes, is guaranteed to stall any further progress in this area of healthcare.

Dr William Behan, General Practitioner, Walkinstown, Dublin 12

 

Down-to-earth minister

Regarding Health Minister Leo Varadkar's article in Tuesday's Irish Independent and the revision of the timelines for Universal Health Insurance, as a GP registrar, it is nice to see that we now have a Health Minister who has, at least at some point, visited planet Earth.

Cllr Paddy Smyth (FG), Members' Room, City Hall, Dublin 2

 

'War crimes' in Gaza

Mahmoud Zahedi ('Self-defence in Gaza', 6 August) asks: "Are you calling the shelling of UN schools self- defence?"

"Are you calling bombing of hospitals self-defence? Are you calling the shooting of children playing on the beach self-defence?

"Are you calling the genocide carried out by the second-largest army in the occupied land self-defence?

"All the above are, in any book, war crimes."

May I draw his attention to the provisions of the Geneva Convention, which make the placing of military forces in civilian areas a war crime.

Furthermore, the incidental killing or injuring of civilians is not, provided they have been given warning to leave areas used for military purposes, as the Israeli army has done. That Hamas tries to prevent such evacuation is in itself a war crime.

He may not be aware that Hamas uses schools, hospitals, mosques and apartment blocks for the storage of munitions, the digging of cross-border tunnels and rocket launching, with the deliberate intention that, in any conflict, there will be civilian casualties - proven by its policy document captured by the Israelis in Shejaiya this week. Furthermore, its command centre is located in the basement of the main hospital in Gaza.

Finally, his claim, "When you lock 1.8 million people into one area, how can you distinguish between military and civilian zones?" creates the impression that Gaza is so densely populated that civilians have nowhere to go, which is untrue. The population density of the Gaza strip is lower than that of London. I concede that most of the population is concentrated in a few urban areas, but there are many sparsely populated areas, where there is no military activity, to which they could be evacuated, but for Hamas' insistence that they are not.

In view of the above, I would suggest that Mr Zahedi should be calling for the condemnation of Hamas for its undoubted war crimes rather than Israel, which makes every effort to minimise civilian casualties.

Martin D Stern, Salford, England

 

Smoking out anti-vapers

I am an avid vaper who never vapes where I wouldn't smoke. This is a personal choice and I am disgusted and irritated by the anti-vaping brigade who would like to ban everything that makes them feel "uncomfortable". I am also allergic to cheap perfume, which causes me to sneeze and plays havoc with my sense of taste, but I don't seek to ban it.

Tom Farrell, Swords, Co Dublin

 

Let's celebrate Home Rule

I wish to support John Bruton's call that we celebrate September 18, 1914, as the day Home Rule for Ireland became law. Not alone was it a game changer for us it was also a game changer for the Commons, as henceforth the House of Lords could only delay a bill for one year.

The House of Lords was most likely to veto Home Rule; now the power of veto was gone. Home Rule is what we got in the Treaty of 1921, but with the additional power of raising customs. This extra power proved a disaster. We have now relinquished this power to the EU (children and fools should not be given dangerous tools). De Valera used tariffs to wage a trade war with the UK and made speeches that the British market was gone forever, thank God.

The poverty of farmers led to militancy and forced common sense to return. Despite this costly learning, the Irish Government went on to set up, behind tariff protection, hat making and car manufacture; known as fools' production. They destroyed our egg industry, pig and cattle fattening by keeping out cheap animal foodstuffs.

Next we should celebrate 'The Statue of Westminster 1931', which was the result of a Commonwealth conference of friends, a pay back for supporting Britain in World War I. It was given out of goodwill and the power of love.

World War I had ended the love of power - as in imperial ambition. Full independence, or as much as they wanted, was given to the Dominions: Canada, Australia, New Zealand, South Africa and Ireland.

Britain gave away more territory than the whole of Europe. Its goal in World War I was not empire building but to make the world a safe place for democracy and defend human rights. De Valera used his increased independence to remove the governor, the oath and to bring in the 1937 Constitution.

Noel Flannery, South Circular Road, Limerick

 

Undercover garda work

Was the garda who left his laptop in a Dutch brothel doing undercover work under the covers?

John Williams, Clonmel, Co Tipperary

 

Our Dickensian justice system

I would like to compliment your journalist, Eamon Delaney, for his piece 'Let us now get real about crime and start to reform our overindulgent legal system' (Irish Independent, 5 August). He hits the 'proverbial nail on the head' in his description of our judicial system.

Our judges and the Garda Siochana are limited in what they can and cannot do in a court of law.

The Irish system is in serious need of a major overhaul as it is quite simply, Dickensian.

James Campbell, Carrick-on-Shannon, Co Roscommon

Irish Independent

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