Manifesto review 5 – health and the Green Party

The Green party manifesto has some good ideas on health. The ‘social affairs’ part of their manifesto is headed ‘Efficiency in Everything we do’, and it’s not a bad summary. Their key idea is ‘to develop patient-centred care, to prevent problems before they occur, and to create a world class health care system that is cheaper and more efficient’. This is laudably clear. Do they outline a credible path?

In part yes, but also in part no. One interesting thing about reading a stack of manifestos is that you get an idea of whether the people who wrote them are actually familiar with modern health care delivery or not. The Green Party fails on this. Ideas such as advanced public health nurses, providing care at home; paramedics going to homes, and keeping people out of hospital; combined physical and mental health polyclinics; do not suggest a strong grasp of what modern health care is about. There is also very little on social care, little on care for the elderly, nothing on chronic disease, little on general practice, and no suggestion of removing drug co-payments.

They plan to replace HSE with Community Health Organizations, ‘which will include a balance of community and patient participation advised by health care professionals. This is possible, but would be very disruptive. They have some good ideas on disability, but surprisingly do not suggest individual care budgets. They also support a sugar tax, which I welcome, better food labelling, and limits on marketing of food to children – the ‘Sydney principles‘.

Their most innovative ideas are on health care financing and funding –  They want a single-tier health system, funded largely from general taxation. They support multi-annual budgeting, Activity Based Costing and blended Capitation Schemes, to encourage efficient use of resources. These are really good, really radical (by Irish public sector standards anyway) ideas, which could make a big difference.

They say little about general practice, apart from suggesting  more investment in services to allow for ‘minor procedures and specialist services’ to take place outside of hospitals. This kind of misses the point.

Overall, they have some good ideas, and a plausible vision. They show little sign of knowing much about the detail of providing modern health care, and there are no detailed costs. They suggest €625m over five years, which I think could only cover a fraction of their aims.  Some of the financial changes proposed could have a big effect on the quality of financial management within the sector, and these are very welcome.

This entry was posted in Health.

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