Health Service Costs

The Minister for Health, Mr Martin, and the Coalition Government misled the public on the issue of health services in advance…

The Minister for Health, Mr Martin, and the Coalition Government misled the public on the issue of health services in advance of the general election, when they promised there would be no reduction in services. Now Mr Martin is adding insult to injury by distancing himself from the cost-cutting measures ordered last month by his Department and suggesting the cutbacks now in train will not impact on the quality of patient care. The brass neck of the Minister is astonishing. We can expect more of the same as the Government's fiscal situation worsens next year.

The seeds of the current problems were sown in 2001 when some health boards recruited extra staff and exceeded their budgets. At the same time, the Minister himself extended universal free medical care to the over-70s at a huge cost to the Exchequer and to the detriment of low-paid families which might otherwise have been covered by the medical card scheme. As the election approached, the purse strings remained open. Pledges were given that there would be no cutbacks or diminution in the level of medical services being supplied. In fact an expansion in a variety of areas was promised. An election had to be won. And because health was the top issue on the public's agenda, nothing was done by the Government that might cause disquiet to citizens.

Now that the Government is comfortably back in office, regional health boards are under instruction from the Department of Health to rein in their spending programmes for this year by an estimated €50 million. One of the consequences of this has been a strike by junior hospital doctors as health boards attempt to reduce overtime costs. The number of agency nurses being employed has fallen and hospitals have begun to defer the purchase of equipment and to cancel non-essential medical procedures. Difficulties are likely to intensify in the autumn when the benchmarking process comes to be addressed. Nurses have already threatened industrial action in October if their demands are not met.

There are two options facing the Government: provide extra resources for health services through increased borrowing or taxation, or demand greater value for money, with a consequent reduction in services. Mr Martin has said the matter of higher taxes will be a matter for his Cabinet colleagues. But he knows the Minister for Finance, Mr McCreevy, is already committed to securing better services from existing resources. This "pass the parcel" approach has been a hallmark of this Government. During the election campaign, the Taoiseach, Mr Ahern, promised to abolish hospital waiting lists within two years. It was a claim discounted within days by Mr Martin. But all agreed that the quality of health services would be sustained and improved after the election. Waking up to financial reality after playing Rip Van Winkle for more than a year carries its own responsibilities. The public sought and was promised a fair and efficient health service. It is now up to the Minister and his colleagues to deliver.