Manifesto review 3 – health and Fianna Fáil

Fianna Fáil have published their manifesto. I’m going to concentrate on both the strengths, and what I see as the weaknesses of their health care proposals. The title given to this section of their manifesto is telling. ‘Support a publicly funded health care system’ is what it says, and that is pretty much what you get. The presentation is a bit scrappy with 32 promises, some very general, such as ‘Reform the Health Budget’,  ‘Expand GP Care’ and ‘Improve the Health Service Executive’, and some very specific, such as ‘Increase funding for the Fair Deal scheme’, ‘Recruit an extra 500 Consultants’, ‘ Employ 4,000 more nursing staff’ and ‘Hire an additional 50 dental surgeons’.

There are some definite swipes at the current Government, notably ‘Reduce scheduled waiting times to the international standard of six months by re-activating the National Treatment Purchase Fund’. Translated this means moving resources to provide care in the private sector, so reducing waiting times, by restoring one of their pet schemes, from an earlier FF/PD government.

There are many positive features – for example the commitment to barring privatization of existing service providers, including hospital groups, and the health insurance function. For HSE, they are committed to making it work better, although there are some weasel words about removing under-performing managers to posts more commensurate with their capabilities’, whereas what is needed is the courage to lose some of these people. There is a strong, and welcome emphasis on primary care, community care and General practice, with items like ‘ Rebalance the Health budget towards Primary Care’, ‘ Boost Community Pharmacists’ and ‘Support General Practise’. They propose recruiting an extra 250 GPs by 2021, which is, at least, a start.

There are some nods to public health and disease prevention ‘ Establish an Office of Alcohol Control’, although this is silent o n reducing the overall intake of alcohol, ‘Make Smoking History’, which builds on Micheál Martin’s greatest achievement when he was Minister for Health, and ‘Promote Healthy Living and fight obesity’ which includes a personal favourite of mine – a sugar tax.

There are some innovative ideas. They propose to ‘ Establish a new National Mental Health Authority’ on the lines of the Road Safety Authority, to improve mental health, and reduce the toll of suicide. They also commit to finishing the implementation of ‘A Vision for Change‘, which would be a very welcome development. It’s not clear whether the 2,700 extra staff they propose to hire here are already included in the various others announcements of extra staff elsewhere in the manifesto. I’ve asked for clarification on this and will update when I get it. They propose improving care for those affected by cancer and dementia, and they commit to establishing proper neuro-rehabilitation services. All of these are welcome.

Taken all-in-all there are good parts, and some good ideas, but there is no trace of an overall vision. Much of it harks back to the past, for example refurbishing HSE, and re-establishing the NTPF. They want the service we have now, but with some of the rough bits smoothed. These are not bad ideas in themselves, but they would leave all the (expensive) perverse incentives in our health-care system firmly in place. We would still have a  very unfair two-tier system, and it would still be hospital focused. General practice is, at least, acknowledged, but I’m not sure that tits central role in modern health-care is understood. The phrase ‘universal access’ occurs only once in their manifesto (p 24), and there it refers to ‘universal access’ to fast and reliable broadband! These policies will not fix our problems.

This entry was posted in Health.

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