Al writes about Universal Healthcare and the reasons behind a new Irish campaign on the subject

How many more TV or Radio programmes will we watch and listen to about the health services before we shout stop.  Prime Time, Frontline, Pat Kenny, Joe Duffy and many other shows have featured heartbreaking stories about people waiting for days to be admitted from Emergency Departments, older people whose families cannot get the help they need to look after them, people waiting months for appointments for tests, to see a consultant, children who cannot live at home and have to go to a garda station each night to try and get a bed in a hostel, children in care who cannot get the services they need.

The list is endless and it goes on and on.  Groundhog Day doesn’t begin to describe it. What is going on? Who is responsible? Is it the Minister? Is it the Department of Health?  Is it the HSE? Where does the buck stop?  Where does the money go? What is the budget of close to €15 billion spent on and how come in a country of just over 4 million people, with over 40% of it’s population covered by Private Health Insurance we are still going round in circles? How come?  How come when so many people have written about the state of the health services, Susie Long, Rebecca O’ Malley,  Maurice Nelligan, John Crown, Niamh Brennan, Fintan O’ Toole, Sarah Burke, Maeve-Ann Wren and many more we still seem to be in the same old place.

Well here’s the thing…….Prime Time, Frontline, Pat Kenny, Joe Duffy all bring in the HSE to account for what has gone wrong but they don’t mention, talk about or confront the elephants in the room.

The first one and it’s probably the biggest is how we finance our health services.  We have a health system which is unfair, it is inequitable, it is a two tier system of public money and private health insurance with a “for profit part�? element which is expanding – private for profit hospitals, co location of private hospitals, private finance to build primary care centres.  Access is based not on need but on ability to pay. How many times do we need to say that before the penny drops and we seriously look and change how we finance the health services? The next one is closely linked to the first, those working in the health services work on the basis of being individual contractors, e.g. Consultants, GP’s, Radiographers, Speech & Language Therapists, Nurses, Psychologists, etc.  They are aligned to their professional organisations, they care about their patients/clients but are they accountable?

Here’s the next one, the health services are made up of hospitals both public and voluntary (always thought that was a complete misnomer!)  and social care agencies who are aligned to their own management boards. They get public funding but their main line of accountability is to their own Boards of Management. Here’s the next one, the HSE is not an executive, the definition of Executive is “A person or group having administrative or managerial authority in an organization�? the HSE does not have authority be it administrative or managerial rather it is the Patsy for what is wrong with our health and social services.  A Patsy is the fall guy who is blamed and ridiculed. Listen to the consultants, the doctors, the nurses, the social workers, the psychologists, the radiographers, etc they talk about “them�? and who is “them�? well of course it’s the HSE. But, they don’t work for the HSE, oh they get paid by the HSE, they have HSE terms and conditions of work but they don’t see themselves as being part of or working for the HSE. Read the papers, listen to the radio, watch the television and you will know that the only people working in the HSE are administrators and managers and sure we know there are too many of them! All the HSE does is cut budgets and close services! Here’s the last elephant, its successive governments who have continued to propagate and support the two tier system alongside protecting the medical led status quo.

Well enough is enough.  We believe there is a chance to change things.  We are coming up to a general election and between now and the election we want to build a coalition for change, a coalition that says loud and clear we no longer want a two tier health system, we want a fair and equitable health service which is open to people based on need. A health service which provides health and social services based on need and not on ability to pay. A health service which is able to harness the professional expertise, knowledge and practitioner base it needs to provide the totality of health and social services for its population without a divide between public and private.  There will be no public and private, there will be one health service.  This will not be easy, it will be a mountain to climb, it will mean confronting the elephants in the room.  But, we believe it can be done and the time to begin is now.  By building a strong coalition for change, a coalition for a Universal Health Service we will be calling on all the political parties to come to the electorate with a detailed plan of how they will put in place a Universal Health Service.

You can find out more, join our coalition, support us by logging on to http://www.iuhc.org/