Ireland ‘unbelievably incompetent’ at managing health spending

Ireland has been spending “like drunken sailors” on healthcare over the past 20 years but has very little to show for it, a conference on patient rights has been told.

An ageing population is being used as "an excuse for failure" when the real problem is that the health service is "wholly unresponsive", according to Anthony Staines, professor of health systems in Dublin City University.

The Irish Patients’ Association, which organised the conference, called for equity of access to healthcare to be enshrined as a right in the Constitution.

“There are so many areas of inequity of access to healthcare in Ireland and indeed Europe, so it is time for this conversation,” the association’s co-founder Stephen McMahon said.

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Prof Staines said Ireland was “unbelievably incompetent” in controlling costs in health. “We’ve been spending like drunken sailors since 1999 we’ve got very little for that, we’ve put in the money and we haven’t got the services.”

In international terms, only Switzerland and the US spend more than Ireland on health, he said.

Of eight treatment centres for cancer, he pointed out, four are in the same city - Dublin - yet there is not a single major trauma centre for the country, despite 20 years of discussion.

‘Out of control’

“When you fail to deliver adequate capacity in services, things get out of control very quickly,” he said.

Most health services documents are written by management consultants, he said, adding: “If I wanted to improve services by 5 per cent instantly, I would bar every consultant from the health service.”

He criticised a “level of tolerance for serious misbehaviour” within the system, saying he had seen behaviour within the HSE that should have merited instant dismissal “and yet it goes unremarked”.

Prof Staines also criticised a “serious deficiency” in providing even the most basic information on the health service. It was “beyond disgraceful” for instance that Ireland was unable to provide a breakdown of healthcare costs by age, as most other European countries do.

Age is not the major cost for healthcare, he argued. “Proximity to death is the major driver of costs; age is just a marker.”

Elderly people

While Ireland’s population of older people was increasing, “we are not getting an enormous flood of elderly people” and this country is “on the right side of all the curves” for population within Europe and will remain so for many years to come.

The key to improving services, he said, lies in a “culture of fanatical attention to detail” to deliver excellent healthcare.

Mr McMahon pointed out that almost half the Irish population don’t have private health insurance and depended on the public system.

“They sit on a carousel sometimes like unclaimed baggage as they await their turn - this is unfair,” he said.

“We’re still in a space where we have so many innovations, plans and strategies and yet at the end of the day we still have so many patients finding it so difficult to get access to the care they need.”