Access to good healthcare services is a basic human right. Social justice demands that such access should be available to all on a fair and equitable basis, irrespective of their social status or income level. Our present system is not providing that access.
It is not acceptable that public patients should endure pain and hardship waiting long periods for badly needed treatment. It is not acceptable that some people spend literally years waiting for a hospital bed. And it is not acceptable that we should have a two-tier treatment system which, despite the best efforts of many dedicated professionals, often fails to deliver treatment to public patients when they need it.
It is time to put a permanent end to indefinite public waiting lists. That is why the Progressive Democrats are now proposing a radical new initiative that will help to transform the Irish public health system.
Under our proposals:
every patient currently on a public waiting list would be given a definite appointment date for treatment just as private patients are;
if implemented now, all waiting-list patients could be offered a definite appointment before Christmas; the current waiting list of over 26,000 public patients would, in practically all cases, be eliminated within six months, and the concept of the public waiting list would be ended permanently, never again to become a feature of the Irish public health system.
These are bold and ambitious objectives; but they are achievable. Money alone will not solve the problem: we need new ways of thinking and acting.
We need investment, reform and, ultimately, the transformation of patients' experience of the health services they actually receive.
Certainly we must commit substantial additional financial resources to our health system. But we must ensure that the extra money translates into a real improvement in the service delivered to patients. And that will require a willingness to take fresh look at the way we do things in our health service.
How would our immediate proposal work?
we will establish a new treatment guarantee fund as an additional line item in the central health budget;
all consultants will be asked to provide an appointment for treatment for public waiting-list patients in their private practice; they will be paid fees for treatments as for private patients;
if a consultant is not in a position to offer an appointment, we will seek treatment for the patient elsewhere in Ireland, and, if necessary, in Northern Ireland, Britain or continental Europe;
on an ongoing basis, any patient who has waited three months will be offered a definite appointment date as a private patient instead of simply being put on a public waiting list, as at present
Consultants and GPs will remain at the centre of clinical decision-making.
Effectively, what we are saying is that no longer will public patients have to bear the cost of the deficiencies in the health system. There will be no more indefinite waiting times. People will get the assurance of treatment. The unfairness of an enormous difference between waiting times for private and public patients will be ended.
At present, our public health system aims to treat adult patients within 12 months of going on a waiting list - but nearly half of all adults have been waiting more than 12 months. The target for children is six months - but nearly three quarters of children wait more than six months. And neither children nor adults are given definite appointment dates until the very end of their wait.
A lot of work has been done under the Waiting List Initiative since 1993. £75 million has been allocated to it by this Government since 1997. But progress is simply not fast enough. The waiting list has fallen by just 6,000 in that time. People deserve and demand more.
Our plan will be a major improvement. While we are building up capacity and addressing the long term issues, our proposal would put in place a treatment guarantee for patients.
The Government is shortly to approve a comprehensive health strategy which will deal with all areas of the health services over medium to long term horizon. This initiative which the Progressive Democrats are bringing forward will complement the medium- and long-term steps needed to deliver the health services we deserve in Ireland.
I am confident that the private side of medical practice in Ireland will respond to meet this challenge. There is some additional capacity available in certain areas already. We must make use of all medical capacity for our people. The bottom line is, people must have treatment when their doctor says they need it. The patients must come first.
Mary Harney is Tanaiste and leader of the Progressive Democrats