Hospital consultants have said they would not support a proposal from the Fine Gael leader, Mr Enda Kenny, that patients who try to follow medical advice should be given priority in medical care over those who do not, writes Mark Brennock, Chief Political Correspondent.
Mr Kenny's proposal came in a keynote speech on the subject of rights and responsibilities yesterday. As well as suggesting priority for "responsible" patients, he said Fine Gael would be producing policies on restorative justice, parental responsibility for their children's actions and victims' rights.
The party would be putting forward a "new politics" which "allows people to claim their rights while living up to their responsibilities".
Mr Kenny said health was a critical area where rights and responsibilities had to go together.
While every patient had a right to "appropriate, efficient and effective health care they also have responsibility to take better care of their own health".
He suggested that those continuing to smoke or drink excess alcohol against medical advice were not discharging their responsibility. "We believe that priority should be given to those who have demonstrably taken responsibility for their own health, who, if they are diagnosed with illness, genuinely try to heed the medical advice given, be it to overcome their addiction to smoking, to tackle their dependence on alcohol or to get more exercise."
However, the assistant secretary general of the Irish Hospital Consultants Association, Mr Donal Duffy, said doctors would not support such an approach.
"Tobacco, for example, is an addictive substance. It is difficult to defeat. I don't think the medical profession would be supportive of giving any less priority to a person who is addicted to a particular substance. The priority will remain medical need."
Mr Kenny was in Cork where he said he believed there should be a new focus on how best to balance rights with responsibilities.
At present, were al-Qaeda to attack US interests in Ireland, we would have to call for outside help. Fine Gael's recent foreign policy document suggesting the abandonment of Ireland's traditional neutrality and greater engagement with international security was an example of the balancing of rights with responsibilities, he said.
Public servants' right to a good salary and their benchmarking pay awards should be linked to the responsibility to provide better public services. He said the opportunity to use benchmarking to "join up the rights and responsibilities of all those paid by the public" had been "squandered".
However, the president of the Irish Congress of Trade Unions, Sen Joe O'Toole, responded by saying there was a 56-page document in the benchmarking agreement outlining agreed improvements in public services.
These were under the headings of education, local government, health and the civil service, and progress in them was to be monitored by a quality assurance group.
"People will always say it is not enough, but it is wrong to say benchmarking isn't tied to improvements in public services."
Mr Kenny said Fine Gael was looking at "new ideas" in the area of health, besides the one about giving priority to responsible patients. Examples included offering every citizen a free annual health check, and introducing a vaccination "smart card" which would contain all information on vaccinations a person received.