Will yesterday be remembered as "the point from which a good health service was developed into a great health service", to use the words of the Minister for Health, Micheβl Martin, at yesterday's launch of the Government's new health strategy? What distinguishes this strategy from its predecessors? There is the assessment of tremendous spending needs over the next seven to 10 years - £10 billion in total. Increased capital spending, at £6 billion, is three times the health spending allocation in the National Development Plan. Current spending needs to have increased by £4 billion in ten years' time to fund planned additional services, on top of new funding to maintain existing services.
These are sums to make any Minister for Finance pause. Small wonder then, that Mr McCreevy, who is openly sceptical about health spending, has been debating the merits of this strategy with Mr Martin virtually to the eve of its launch. The greatest strength of the strategy lies in the compelling case it makes for the need for extra health spending in our historically under-funded system.
Is the strategy to be interpreted as a commitment by this Government to implement such health spending increases in the event of its re-election, notwithstanding Mr McCreevy's rearguard action? And if so, how are they to be funded? Has the Fianna Fβil/Progressive Democrat coalition adopted, like the Labour Party, an ongoing commitment to putting social spending before tax reductions? Would it contemplate tax increases? The probability of achieving the strategy's targets can only be assessed when those questions are answered. If they are not, then the Opposition's charge that this is purely an election platform will have some justification.
More detail on the strategy has yet to come: a primary care document and the value for money audit of the health service have yet to be published. The Budget will reveal the new income eligibility limits for medical cards. The strategy's objectives for better care for public patients critically depend on delivering a greatly altered consultants' contract in negotiations with the medical organisations.
Public patients will greet proposals to shorten their waiting time for treatment with relief. But these are targets, not guarantees, and may provoke unwanted consequences in the complex two-tier system. Given the opposition parties' commitment to dismantling the two-tier system, the Government may yet come to regret its reluctance to do so.