Tax breaks for private healthcare perverse, says Ictu

The subsidising of all private healthcare provision should be phased out and a single-tier health system created, an Oireachtas committee has heard.

The Irish Congress of Trade Union (Ictu) has described the tax incentives offered to those who access the private system as “perverse”.

In its submission to the Oireachtas all-party committee on the future of healthcare, Ictu has advocated a move to a “universal, fully integrated, single-tier public health service”.

A universal public healthcare service should be funded with a minimum of 10 per cent of GDP per annum from progressive taxation, it has said. This does not include money set aside for capital programmes within the health service.

Underpinning a single-tier public health service would be the provision of a network of locally-based healthcare centres.

Delivering the submission, Ictu general secretary Patricia King said it envisaged the public health system being an "employer of choice capable of attracting and retaining the most talented staff".

Ictu executive council member Liam Doran said the move to a single-tier health service will "take far more than a decade" and will need a multiannual funding commitment to achieve.

He anticipated that the change will take at least 15 years. The process should begin immediately with the recruitment of hospital consultants working exclusively in the public health service.

"The goal must be by the time we reach 2030, the citizens of Ireland will live in a country that promotes the maintenance of good health and responds to ill-health regardless of socioeconomic status or where you live".

Radical overhaul

Irish Nurses and Midwives Organisation (INMO) president Martina Harkin-Kelly backed the call for a minimum of 10 per cent of GDP to be spent on a publicly-funded health system.

She told the committee that the healthcare needed a “radical and transformational process of change” leading to a single-tier health system.

She forecast that it would take 15 years and need “political consensus stretching far beyond the normal electoral cycle”.

Dr Peadar Gilligan, chairman of the IMO consultant committee, said the ability of hospital consultants to treat patients has been "truly compromised" by cutbacks in the health service.

The reduction in bed capacity in recent years is having a ripple effect in every hospital in the country, he said. There are 12,800 acute beds within the hospital, 800 fewer than in 2008 and 1,300 fewer in-patient beds.

The Department of Health stated in 2003 that 14,700 beds would be needed by 2011.

“Unless urgent steps are taken to remedy this shortfall, we will continue to experience significant delays and preventable deaths,” he said.

Dr Gilligan said the health system is “grossly understaffed” and both consultants and non-consultant hospital doctors have workloads that are jeopardising healthcare standards.

He added: “It is little wonder that few doctors see staying in Ireland as an attractive choice or one compatible with their professional development.”

Accordingly, Ireland has just 2.8 doctors per 1,000, less than the EU average of 3.4 doctors per 1,000 with the highest dependence on foreign doctors.

He described the cut of 30 per cent in pay to new hospital consultants as “catastrophic” for recruitment.

There are 250 unfilled consultant posts, he said, with a quarter of all posts receiving no applicants at all.

He also stated that the IMO’s own research has found that just 40 per cent of Irish medical graduates intend to practice in Ireland.