Better4Health starts with ‘Universal Health Care, not Universal Health Insurance, is the solution’, which is now pretty much common ground amongst all the parties except Fianna Fáil. A huge amount of work was done on costing these proposals, but ran into some challenges .My favourite is this ‘Our costing development work was further frustrated by the staggering deficit of data held centrally by either the Department of Health or the HSE. On a number of occasions, they simply would not, or could not, provide the basic data required to determine what we are currently delivering for our spending. This in itself is of serious concern.’
Their analysis of overall health expenditure is spot on. We spend quite a lot, and we do not get a reasonable return from this expenditure. Their solution, which is to spend a lot more, does not seem obviously reasonable, or indeed likely to work at all.
In detail, they divide their solutions up under three headings – Equality, Capacity and Funding. They will hire 6,600 more staff, almost all in hospitals, remove prescription charges, and provide free GP care for all on a phased basis. As far as I can see almost none of the extra staff will be actually working in general practice, which is a major omission. They plan only 200 more practice nurses, which is a drop in the ocean, and an extra 40 trainees a year, which will not keep up with retirements.
They will bring in taxes on sugary drinks, minimum unit prices for alcohol, and more resources for drug treatment. They will also regulate food marketing. They have some good ideas in mental health, including specific suicide prevention actions, more resources for children’s mental health, and better access to counselling in primary care.
Overall,this is a policy which identifies problems, and some solutions, but fails to fund some of the key actions. For example, under managing chronic disease, they suggest hiring more consultants, care plans for people with asthma, and screening for coeliac disease. This is a rag-bag of ill thought out ideas, and will not address the huge challenges facing our health services in dealing with long-term illness. There are good ideas here, and the overall goal – universal health care, is worth reaching for. They have put a lot of work in, perhaps more than any other party, but they have missed the mark.