BY 2027, THERE might be a lot of things you might want to happen. You might want the courage to ask your barber for a different haircut for the first time since 2008. You might want to climb Mount Kilimanjaro.
You might want to go back into further education. And, you might want to get the health care you need, when you need it, regardless of your bank balance.
For many of us, this is pie in the sky stuff, just about in the realm of possibility, but unlikely to happen all the same. Last week though, we took a first step towards that last target. We were given a plan.
Sláintecare report
The Oireachtas Future of Healthcare Committee published its Sláintecare report which offers a design for our health services for the next ten years, that will break up the two-tier system you’re probably resigned to being trapped in and just want to forget about.
It is a cliché at this point to say “this will just be another report left on a shelf somewhere”. This is likely a result of years of learned cynicism, particularly in a deeply dysfunctional health sector, where plans are abandoned in less time than it takes to set up an independent inquiry.
We at the Health Reform Alliance welcome, support and will champion this plan though.
It is, admittedly, imperfect. Political solutions to the most wicked and weighty societal problems tend to be. This does not however, render it somehow invalid or impure.
The report was never going to be perfect
The Committee’s report, painstakingly pulled together by fourteen politicians from seven different groupings over the course of eleven months, was never going to be perfect.
As an alliance of health and social care organisations who represent a variety of patient groups, we know the innate difficulties our pernicious and peculiar system of healthcare provision imposes on patients, and this report will mean real improvements.
It will mean that if you need to get a test done for cancer, colitis or cardiovascular disease, you won’t have to wait months on end and you can do it in an appropriate facility, closer to home. It will mean you pay less for essential medications, it will mean your parent(s) can get home care and retain their independence, it will mean you won’t be left out of pocket every time you need to visit your GP, and it will mean better outcomes for your life.
It will also mean system changes and the redirection of services so they’re delivered at the least complex level, the creation of more posts to provide appropriate care and let consultants, GPs and nurses practice at the top of their licence, technological improvements to ensure a more efficient and cost-effective service and more accountability right across the health service. This is an ambitious strategy with the potential to revolutionise the delivery of healthcare.
What are the costs?
Obviously, this sounds appealing, but what are the costs? The costs are by no means insignificant with around €5.8 billion earmarked over ten years for capital expenditure and transitional funding to replace cuts made to the health service in the past decade. Ultimately though, the cost if we don’t choose to invest will be vast and destructive.
If we stand still, and don’t reorient the health system so that care is carried out at the lowest possible level, our hospitals won’t be able to carry out elective procedures and will deal only with emergency care, costs will spiral as we face into a chronic disease crisis accompanied by an ageing population, and public hospitals, in their attempt to maximise private patients to meet private income targets, will ensure our seemingly endless waiting lists will get longer.
We’ll also face the human costs – overworked, overtired staff, people who can’t access a bed or care at home, patients diagnosed later than they should be and many financially crippled by punitive out-of-pocket charges.
Where grand ideas falter usually isn’t far after the planning stage, but we can’t afford for this plan to fail like so many before it. What good, ambitious ideas often need to progress from plan, to implementation, to reality, is courage. It’s the courage for you to take that first step and book that flight to Kilimanjaro rather than talking about it interminably, it’s the courage to ask your hairdresser “can you do something like this picture?” instead of “the usual”, and it’s the courage to apply to that course you’ve always wanted to do.
Courage isn’t easily summoned, and there are many reasons not to grasp the nettle of our thorny healthcare system, but there are dire consequences to not invest sufficiently in it. Our political leaders, especially our next Taoiseach, must take the first step and ensure an Implementation Office for Sláintecare is set up by its July target.
Leaders from across the political spectrum also need to support Sláintecare. It’s not enough for the TDs who sat on the Oireachtas Committee to trumpet its proposals, but it is incumbent on party leaders and parties to follow suit, ensure the consensus this report brings is not forgotten or cast aside in pursuit of political capital, and forms the bedrock of Irish health policy for the next ten years.
It will be a battle to ensure its full implementation, but the Health Reform Alliance and its member organisations will champion this imperfect, but imperative plan, so we can all get the care we need.
Paul Gordon is the Chairperson of the Health Reform Alliance, an alliance of health charities that supports reform of health and social care. The Health Reform Alliance’s ‘Future of Healthcare – Policy Forum’ will take place on Thursday, 29th June from 10am to 12.30pm in the Woodquay Venue, Civic Offices, Wood Quay, Dublin 8.
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