LAST WEEK, THE news broke that there were now twice as many people waiting over three months for a colonoscopy. More than 2,400 people. And 71 waiting over a year. Colonoscopies are critical for diagnosing bowel cancer in time. In my mind, it cannot but be the case that some of these will suffer the same fate as my wife, Susie Long.

Next month it will be four years since Susie died after a difficult battle with cancer – having waited seven months for a colonoscopy that private patients at the same hospital were able to access within days. This in itself was not unique. That we have a two-tier health system that actively discriminates in favour of those who can pay at the expense of those who can’t is common knowledge.

What made Susie’s case unique was that she fought back. She fought not for sympathy, not for compensation, not for any petty personal motivation, but for justice. She asked: “Why is my life worth less because I can’t afford to buy private health insurance? Why should someone who works hard and contributes to society be disregarded by that same society when they are most in need?”

It was the health cutbacks in the 1980s which left St Luke’s Hospital in Kilkenny without a Day Unit capable of processing colonoscopies at a sufficient rate to prevent a long waiting list. Back then it was Fine Gael and Labour who introduced the cutbacks and it was Charlie Haughey’s Fianna Fail who followed, telling us to tighten our belts (having first won the 1987 election on the slogan: “Health cuts hurt the old, the sick and the handicapped”). More recently Tweedledum and Tweedledee governments have come in reverse order but still the hypocrisy is ever-present.

In the 1980s the golden circle had their Ansbacher accounts for stashing their cash. Today we find inequality at even greater levels. Just as the great mass of Irish people are struggling to keep their heads above water, our 300 richest citizens are worth almost €57billion, with €6.7billion being added to their combined wealth over the last year.

Inequality kills

Inequality kills. For this there is plenty of evidence. In 2001 a report called Inequalities in Mortality was published by the Institute of Public Health in Ireland. In it the health outcomes of the lowest earners in society were compared to those of the highest earners. What they found was shocking and I think it deserved far more attention from the media. It found for that the mortality rate was 100-200% higher for all causes of death:

• For circulatory diseases it was over 120% higher
• For cancers it was over 100% higher
• For respiratory diseases it was over 200% higher
• For injuries and poisonings it was over 150% higher

Why is €30billion of public money being poured into the banks to rescue the rich speculators and gamblers whilst the health service is being starved of cash? Shouldn’t it be redistribution in the opposite direction? A 10 per cent wealth tax on our 300 richest would solve a lot of health funding problems. But when you see that the health service is being primed for privatisation you realise it’s not just some oversight by the government but an actual plan – to carve up our public health service for private profit.

Fine Gael’s ‘Fair Care’ policy is based on the universal health insurance system in the Netherlands. Despite a 20 year lead-in time to build a comprehensive regulation system and commodify the health system into 30,000 ‘diagnosis and treatment combinations’, the insurance vultures have left 50 per cent of Dutch hospitals on the verge of bankruptcy. And this is the system they want to bring in here.

It is not deemed ‘fashionable’ or ‘polite’ to talk about class differences or class struggle. But we have to start because ours is a society starkly divided by class. The rich and the powerful always look after their own, even at the expense of our lives and our health. It is the labour of ordinary people who create the wealth of the country, who build the roads, teach our children, who keep society running. Without us the country would grind to a halt. It is time we recognised just how powerful as a collective we are and reminded those who try to keep us down.

A decent public health service is not a privilege that is granted to us by those in power. It is an entitlement for which we have worked and paid our taxes.

Conor Mac Liam is a committee member of the Susie Long Hospice Fund providing end-of-life care for patients in Kilkenny, and also teaches in a secondary school.