2014 - an apocalyptical year for health?

  • Niall Hunter, Editor

For the more superstitious and apolyptical conspiracy theorists among us, the number 666 has all sorts of sinister meanings.

The Budget has brought us the somewhat devastating news that a sum of €666 million has been targeted for next year in various cuts and savings measures.

Those listening to the upbeat 'post-bailout' message from the Taoiseach in recent days obviously didn't realise that the good news that we were finally approaching 'morning in Ireland' (to paraphrase Ronald Reagan), didn't apply to the health service.

Bringing the Budget forward by a couple of months hasn't exactly meant that Christmas has come early for the sick, the poor and the vulnerable.

The Government's reduction of the overall savings target from €3.1 billion to €2.5 billion doesn't seem to have provided any sort of palliative medicine for our deteriorating health system.

Yes, you can cite the granting of GP visit cards to young children as some 'good news', but in light of what might happen to the service as a whole next year, this is essentially a sideshow aimed it seems, primarily at saving some people's political skins.

The commentariat, and more importantly, the service users who will be directly affected by the latest retrenchment could be forgiven for predicting that 2014 will be an apocalyptic year for the health service, and not in a good way.

Our national financial collapse and subsequent bail-out has had a devastating and disproportionate effect on the health service, particularly on the sickest and most vulnerable using that service.

The 'number of the beast' cuts target for next year means that during our devastating economic recession, around €4 billion will have been lopped off the health budget.

This, remember, is a budget provided for a service that is seeing increased user demands from the sick and the poor.

Even taking into account the need to implement some efficiencies, slicing that much off a health budget has what any health bureaucrat worth their salt would call 'risk managment implications'.

Worryingly, recent healthcare scandals have raised the question of whether 'doing more with less' is compatible with running a service that is safe as it should be.

The list of cuts for next year appears to be focused largely on hitting medical card patents.

The Government appears determined to exact revenge on those ingrates who insisted on becoming poorer and sicker during the Great Recession.

The presentation of this year's health budget measures have little to do with providing optimal care and everything to do with excessively zealous bean-counting.

And frustratingly, that bean-counting tends to be woefully inaccurate and even irresoponsible, underestimating as it does the level of demand on the service and the likelihood of some of the savings measures being achieved.

The health service has had to be bailed out with a supplementary allocation for each of the past five years, and this year it will need an end of year cash supplement of over €150 million.

Looking at the measures, you try to be dispassionate about it, but it's not that easy any more.

Yes you can argue (perhaps from the comfort of your golf club) that a €2.50 medical card prescription charge 'isn't that much'. Well, maybe not, but everything is relative, and it has increased five-fold in recent years.

For those in dire straits, the odd euro here or there can make the difference between eating properly or paying a utillty bill.

Yes, removing medical cards from 35,000 over 70s will, probably only hit the higher earners among this age group.

Yet there are mixed messages here in the Government's policy.

It is taking income out of the equation in giving medical cards to the children of lawyers and hospital consultants, yet putting it back in again by reducing healthcare eligibility from some better off older people.

Either the Government is in favour of 'progressive public health initiatives' which allocate benefits regardless of income or it isn't.

Worse still may be the Government's plan to save €113 million under an as yet mysterious initiative to achieve 'medical cards probity'.

There are predictions that a further 100,000 people could lose their medical cards. The Health Minister so far cannot give us precise details of how this probity scheme will work.

Notwithstanding the need to root out any inefficiency or even fraud in the granting of cards, one cannot help but feel that there will be many innocent victims in this ominous process.

Other 'highlights' of the budget health measures include that the service will have 2,600 fewer staff by the end of 2014.This means around 14,000 staff numbers will have been cut from the health service since 2007.

And there's more to look forward to- the HSE's forthcoming service plan will tell us exactly how much less hospitals already making major cuts will be given next year to deliver services.

There will be provisions next year, apparently, to protect staff numbers where they might be needed. Perhaps this may provide some electricians, to fulfil the HSE's new mission statement - 'will the last one to leave please turn out the lights?'

For 2014 could indeed be the year the lights finally went out all over the health service.

Massive health cuts in 2014

Altruism or stroke politics?




Discussions on this topic are now closed.