Early in 1997, in the face of a 27 per cent rise in hospital waiting lists, the Rainbow Coalition decided to cut the funding allocated towards the reduction of waiting lists by 20 per cent.
With an urgent need to provide additional nurse training places, it refused to provide the necessary funding. In fairness, the minister for finance had the courage to admit: "I did not listen to those voices at the time as well as I might and [that] the problems of the present Minister for Health and Children are, in part, related to that."
I am not suggesting deliberate negligence on the part of that government, but rather a misunderstanding of the priorities required of the time and the circumstances. This Government must accept responsibility for its tenure in office from the last election to date and so be it.
Last Tuesday's Irish Times/ MRBI poll confirmed that the state of our health services will be central to next year's general election. Today, rather than advance policies which could effect the real and lasting reform which the system so urgently requires, the opposition parties have settled for quick-fix approaches which, although completely inadequate for the real needs of the health system, are being sold as cure-all solutions to the present problems.
Fine Gael's and Labour's policies are insurance-based and all studies have indicated clearly that these kind of systems increase the amount of resources directed at health service administration. In addition, they place local hospitals in danger of closure. Where local hospitals cannot compete for service contracts from insurance companies, their existence would obviously be threatened.
The root of the problems in the health service is 75 years of under-funding. From Independence to the late 1990s, the service was consistently underresourced. Our doctors, nurses and health professionals have always been among the best in the world; their excellence alone, however, could never substitute for lack of beds, equipment and wards.
By any gauge, this was not a rich country between 1923 and the mid-1990s. The resources required to provide the world-class health service which we deserve were simply not available. By the mid-1990s, however, the economy had been turned around and prosperity at last was a reality. The government of the day, however, failed to begin to address the needs of the health service.
Over the lifetime of that government, the health spend was increased by - in the context - a meagre £400 million. The much-needed additional nurse training places were not provided. Funding towards waiting-list reduction and capital spending was wholly inadequate for a prosperous country.
Improvements take time to implement. There are long but necessary run-in times in all aspects of the services. It takes years to train health professionals, build wards, put together complex health programmes.
Had the Rainbow Coalition put the funding, programmes and training places into the health services in the mid1990s, when we had the money, today's problems would be greatly reduced.
Slowly, the tide has been turned, maybe too slowly and too late for some. Last year 50,000 more day cases and 40,000 more in-patient cases were dealt with in our hospitals than in 1997. I do not contend that all is well in the health service; it is important that we examine the problem fully and acknowledge its roots. We have a good and energetic young Minister for Health who admits there are problems and proposes to act on their resolution.
This Government is advancing a new health strategy in partnership with the health professionals. The nurses, doctors, administrators and general public have had a role in shaping the policy, which should be ready by late summer. Central to the strategy are a number of key reports on the core issues for the well-being of our health service: the Medical Manpower Report, the Report of the Commission on Nursing, the Value for Money Audit, for example.
These have taken a long time to compile, and understandably so. This strategy will shape the health service for decades to come; a quick-fix approach would inevitably have huge negative repercussions down the line. In the meantime, health funding has been doubled and programmes are being put into place which go some way to address the legacy of neglect.
The parties in the last government had the resources to effect real change in our health services and did not do so. They left it to this Government to provide the investment, the planning and the capital spending.
The new health strategy and the partnership of Government, health professionals and the general public which is creating it will have historic and positive consequences for the future welfare of our people.
This article was originally written as Andrews on Saturday and was held over due to lack of space.