Articles from the Nov 2004 edition, the Socialist
Harney's private health plan
I WORK as a nurse in the intensive care unit of one of Dublin's major hospitals. So I feel that I can speak with some authority on the state of the Irish health service. Our health service lurches from one crisis to the next, it operates in a climate of crisis management.
by Ger Hughes
The government claims that the health service is a black hole which swallows up funding at an uncontrollable rate. What the current crisis shows is that the recent increase in health funding is not enough to overcome the major cuts of the past.
What should be at the core of the health service are primary and preventative healthcare, and a new democratic management system which includes health professionals and representatives of local communities to ensure that the needs of patients are top of the agenda.
Healthcare is first and foremost a human right, and the sick should receive treatment irrespective of their ability to pay.
In Ireland this blatantly not the case. There is a direct co-relation between the crisis in the health service and the development of the two tiered system. The deepening crisis in our hospitals' A&E departments, the bed shortages, which meant recently there were 220 patients on trollies, is pushing people to opt for private health insurance.
But the government is consciously behind a drive towards the privatisation of the health service. This is illustrated by the National Treatment Purchase Fund (NTPF). The NTPF is nothing more than a cynical exercise to massage the waiting list figures. The use of private hospitals here and abroad for surgery has the effect of taking funding from the health service while simultaneously having a detrimental effect on indigenous surgical practice by removing these practices from the public system.
The current crisis is fundamentally as a result of the savage health cuts introduced by successive governments throughout the 70s, 80s and 90s. At a conservative estimate, these cuts had the effect of reducing the total acute bed capacity by upwards of 3,000 beds. Bertie Ahern recently told the Dail that 900 new beds were in place. What he forgot to mention was that this number included day beds, trolleys and couches! The government's own study of the situation in the acute hospital system identified a need for at least 2,800 beds and up to 4,300 beds in the next few years.
Mary Harney supports a universal insurance model or what is more commonly known as the American system. This would mean the full scale privatisation of our health service. Health care would simply be viewed as a commodity to be traded for profit, and the needs of the sick would be secondary. If the government gets away with taking the health service down this road, then the crisis we are experiencing now will be nothing in comparison to what's in store.
Health service workers, unions and local communities will need to be vigilant during Harney's term of office. We need to organise and campaign for better funding for health but also against her plans to sell off our health system to the profiteers.
"I want Bertie Ahern and Michael Martin's blood"
SUSAN FITZGERALD spoke to ANNE CLAXTON and her brother DENIS RUDD about what has driven them to join with others in the establishment of "Patients Together", a group campaigning for more resources for the health service. Denis and Anne's father, who worked his whole life died, in an overcrowded hospital accident and emergency department.
"OUR FATHER was taken to hospital on 18 April 2003. Our dad was 89 years of age, he spent Friday through to Sunday evening on a trolley. He eventually got a coronary care bed that he needed on Friday night. During his time in the coronary unit, a desk was being built which meant hammering and drilling with power tools in the actual unit where he was being held. He winced with pain at every blow of the hammer.
"We sat with him through that night, knowing he wouldn't see another full day. At 3.30am the staff nurse in coronary care got a call from casualty to say they needed my father's bed. There was no porter around so we had to push our dying father along with carrying the morphine pump, his assorted drips and also carry his personal belongings. He was put in a side ward he died at 2pm the next day.
"My father set up two Fianna Fail Cumanns in the Liberties and worked like a Trojan for Fianna Fail all his life, he believed Bertie Ahern was going to be a champion. But mark my words now, I want Bertie Ahern's and Michael Martin's blood over what they and successive governments have put people through.
"David Begg [ICTU] and the other unions walked in there not so long ago and signed up to a new agreement. Why didn't he speak about this when Bertie was across the table. We are 100% behind 'Patients Together' as a family. We are going to link up with everyone else who is willing to fight. We think the movement can snowball - we're going to go to where the people most affected are, we'll speak to people in casualties, put up posters and challenge people to fight back. No-one should have to live out their days in the indignity which our father endured."
Health Service in crisis - HARNEY HAS NO ANSWERS
JOE DUFFY, presenter of RTE Radio One's Liveline dedicated a programme to trying to find beds in Dublin for 157 patients who were on hospital trolleys. This ridiculous scenario sums up this government and its neglect of our health service.
by Stephen Boyd
Janette Byrne, a spokesperson for Patients Together in reply to Mary Harney saying it would take time to sort out the beds crisis said, "The people on trolleys and chairs don't have time, animals receive better treatment than some patients in A&E".
On 28 October in the Dail, Bertie Ahern gave a commitment that the government would provide an extra 3,000 beds by the year 2011. Now we can look forward to another seven years of hundreds of seriously ill and dying patients languishing on hospital trolleys on a daily basis.
The government never tires of telling us about the huge amounts of money spent on health. e10 billion in 2004 apparently, and the problem isn't money, no, it's bad management. Apparently we have an inefficiently managed public health service, according to Fianna Fail and the PDs. These arguments are all leading in one direction - that if we want an efficient, cost effective health service, then we must privatise it.
Mary Harney visited A&E facilities in New York during a recent visit. Harney is already on record as favouring an American style, private healthcare system. In the USA 45 million people have no health insurance and it is widely recognised that the US health system is one of the worst in the world as it works on the principle that if you can't pay then you don't get treated. This is what our Minister for Health wants for the Irish health service, to create a whole new arena for profiteers to make money out of people's suffering.
The reason why hundreds languish in pain on trolleys in our A&E departments isn't due to bad management, nor because we need the so-called efficiencies of the capitalist market to regulate how we treat our sick. The answer is quite simple. There aren't enough hospital beds, nurses, doctors or ancillary staff.
In the 1980's various governments that included Fianna Fail, Fine Gael, and Labour all introduced draconian cuts in health spending. Hospitals were closed and between 3,000 and 4,000 hospital beds were taken out of the system. You can't cut 4,000 beds, and expect that we will have an efficient hospital system that can meet the needs of an expanding and ageing population.
Healthcare under capitalism in Ireland today means that: Children can't get essential dental care; the elderly can't afford private nursing homes; parents can't afford to pay e50 to take their children to a GP; Victorian psychiatric hospital services; suffering for thousands waiting for life saving operations, and the dying living out their last moments without dignity on a trolley!
However this crisis could be solved if ICTU and the health unions issued the call for a national campaign against the government. Every family in the country is affected. Hundreds of thousands could be mobilised in protests and demonstrations in every city and town. A mass movement of people power could force this government to provide the funds for a free and comprehensive health service for everyone.
Earlier articles on the Health Service crisis