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Brendan O'Connor: GP card fiasco reminds us that austerity is real

There is a danger that austerity is becoming an abstract concept. This, of course, was always the idea. They would call it austerity, or fiscal consolidation, and present it as a mathematical adjustment. An abstract exercise in mind-boggling numbers concerning something called the deficit, all far removed from the ordinary concerns of ordinary people. They didn't call it a programme of cutbacks and tax increases. Because that would have been more problematic, more real.

And at the beginning people would point out that austerity was not just an exercise in abstract numbers and that it involved real people and real pain. But, actually, gradually, the powers that be managed to decouple the notion of austerity from the reality of austerity. This decoupling was so successful that, for example, the Troika could tell us last week that we are doing well and we need to keep up the austerity, but we need some growth and we need to do something about unemployment. As if lack of growth and unemployment were nothing to do with the austerity. Like starving someone and telling them that the starving is working really well but in an unrelated health issue they just need to put on a bit of weight.

Even though pretty much everyone, even the people responsible for it, is now washing their hands of austerity, we are sticking to it in this country. That is another massive disconnect. One on hand the Government now no longer supports austerity. After Joan Burton, always with a good nose for ordinary people, got out of the traps first to disassociate herself from austerity, other movers and shakers in Labour, including Pat Rabbitte and Eamon Gilmore, have now moved to distance themselves from it, in so far as they can. And Fine Gael is starting to come hot on their heels too.

Internationally, people's clamour to put some distance between them and austerity is almost comical. The IMF has been institutionally and pretty much officially dissing austerity for a while now, and has admitted it got the potential effects in terms of growth all wrong. On the micro level, even one of the IMF men who made the specific plan in Ireland has now admitted it was wrong and that there was too much reliance on austerity. Some of the major economic research underpinning austerity has been proven to be wrong too. And Jose Manuel Barroso of the European Commission has also come out publicly and spoken about it being time for a change. This leaves just one element of the Troika which has not turned its back on austerity at this time – the ECB.

Austerity is also one of those things that unites both left and right. You would imagine Michael D Higgins and Ibec don't agree on much, but they both roughly agree that austerity is no longer working, with Ibec calling for an abandonment of the tax element of the next tranche of austerity. So pretty much no one believes in austerity anymore but somehow our Government keeps mindlessly imposing it. It is almost as if they are institutionalised at this stage. It's just what we do, and don't be asking awkward questions.

The justification for austerity in Ireland is that it has worked, because it has brought the deficit down. And that is the only measure they use. Of course, by definition bringing the deficit down, which is what austerity is, is going to be successful at bringing the deficit down. The real effects of austerity – the mass unemployment, the personal pain that people endure, the lack of growth, the 300,000 people who have left Ireland in the last four years, 41 per cent of whom did so because they had no work here – all these are presented as extraneous issues, additional problems that are nothing to do with austerity. No one likes to point out that those issues are all the whirlwind we reap for sowing the wind of austerity.

There was an interesting mess during the week that might be helpful in reconnecting the continuation of this policy that Government doesn't believe in with the reality of people's lives. This Government had promised, as one of its big election promises, one of the major planks of its manifesto, to bring in a system of universal healthcare for all. One of the first steps in this was to be GP care for all. And one of the first steps in this GP care for all was that it would be extended to people who currently have a long-term illness card.

Some of you may be confused as to what a long-term illness card is. It is a totally different entity to, and awarded on a totally different basis from, the medical card. The medical card is given to nearly half the people in this country based on financial need. The long-term illness card is given to a much more select number of people, 60,000 of them, based on medical need. So you get one if you have various types of disabilities or mental illness and then a few other things like diabetes.

So for example, many children with disabilities that I am aware of have a long-term illness card. It means they get certain prescribed medicines, connected to their specific disability, for free. They pay for any other medicines that are not related to their disability.

These kids with disabilities pay to go to the GP, unless the family qualifies separately for a medical card or a GP visit card. I have met kids who sleep on ventilators in hospital beds in their own houses, who are prone to fits during the night, who have a long-term illness card, but who do not get free GP care.

I have met plenty of kids with Down Syndrome who have the long-term illness card but again, who pay full whack for every GP visit. And while Down Syndrome is not an illness in itself, it obviously leaves people prone to lots of medical issues from heart problems, to thyroid problems to the fact that they get snotted up easily in winter because their pipes are smaller, a cold that can turn very easily into a chest infection which can turn very easily into pneumonia requiring hospitalisation when you are a little kid with Down Syndrome.

I have no doubt there are similar issues with things like Cystic Fibrosis and Cerebral Palsy. And one of the reasons that it might sometimes happen that things are not caught early and dealt with is because sometimes people bargain with themselves and try to take chances. You don't want to be running to the GP whacking out 60 quid every time the child sneezes, so you tend to let it slide and hope that it won't turn into anything this time. It is kind of like trying to estimate when there is a clear and present danger to the child's health.

Notwithstanding that there are lots of very kind, humane doctors around the place who will do a quick check on vulnerable kids and maybe not charge every time, lots of parents of those kids, who have a lot of expense anyway with their disabled children, don't go to the doctor as much as they should, and sometimes they err on the wrong side of caution. And then it ends up costing everyone a fortune. I would imagine that a lot of these parents thought it was very sensible that they would get free GP care for their kids. Indeed a lot of us would imagine that it would possibly save money in lots of cases to encourage these people to make more use, early on, of primary healthcare interventions, rather than letting things fester until they become a serious problem.

The free GP care for that 60,000 people was supposed to begin in March 2012. It obviously didn't happen then. And then the Irish Times announced during the week that in fact this plan had been abandoned altogether. No one denied the Irish Times story but the Government spun it a different way. They weren't abandoning the plan as such, they were just looking at going about it a different way. They were exploring going straight to GP care for all, because the legislation involved in singling out people with long-term illnesses for special treatment was too complex. Apparently half the country is allowed have medical cards but people with long-term illnesses cannot be given free GP care. That would be wrong and legally dubious.

Alex White, who continues to rise without trace in Labour, figured this one out, because he is, as you know, a law talking guy. So two-and-a-half years after the Government made this promise and eight months after Alex White became Junior Health Minister, they have finally come to the conclusion that the legislation would be too complex. Funny how you can liquidate a State-owned bank in a single evening and come up with massively complex legislation to do that, but for sick people – well maybe it's just not worth the effort.

Of course, most of us believe that the complexity of the legislation is just a fig leaf. We accept certainly that the Department of Health in general seems to be fairly incompetent at doing things and we agree that that may be an issue here. But really, we just think it is more of the demolition of the fabric of society in order to feed the beast of austerity, to save money wherever it can be saved without getting a backlash. All to keep at a policy that no one believes in any more but which we continue to use to brutalise our society.

And that's just one more way in which the abstraction of austerity is in fact very real, and another way in which it chips away at people's lives to make things a little bit harder, and to make our society a little bit less humane.

Irish Independent