The Government will rapidly implement politically important elements of its health strategy in the New Year, following publication of the long-awaited document yesterday. The urgent measures include a plan to use private hospitals to reduce waiting lists and the addition of 650 extra beds for public patients by the end of next year.
Funding for these initiatives has been agreed in difficult talks between the Ministers for Health and Finance and will be announced in the December 5th Budget.
The Taoiseach declared the strategy intended "nothing less than to assure a world-class service for every patient". However, it was dismissed immediately by the Opposition as a pre-election gimmick by a Government under pressure after four-and-a-half years in power.
The Opposition parties condemned the failure to end the two-tier healthcare system or to introduce a unified treatment waiting list for public and private patients. "The system which has failed to provide equitable access is to be continued," said Fine Gael's health spokesman Mr Gay Mitchell.
The Voluntary Health Insurance's chief executive, Mr Vincent Sheridan, said last night that private hospitals may not be able to provide treatment for the most common procedures on the waiting list.
The £10 billion, 10-year strategy launched yesterday promises an extra 3,000 bed places for public patients by 2011. The total amount comprises £6.1 billion for capital developments and £4 billion for current spending.
The Progressive Democrats were last night claiming a significant input into the policy through the inclusion of their plan to reduce waiting lists by paying private hospitals to treat public patients.
Mr Ahern yesterday abandoned his usual position of claiming the health service is among the best in Europe, acknowledging instead its serious problems. Waiting lists for treatment were too long, primary care treatment was too rarely available out of hours and equipment and buildings were out of date and substandard, he said.
Next year 650 new beds will be provided and of these, 450 will be public.
However, because of the time it will take to provide the extra public beds, there is likely to be a heavy reliance on the private sector to meet waiting list targets for the next few years, the chairman of the Independent Hospital Association of Ireland, Dr Con Power, said last night, welcoming the proposals.
But a warning in the strategy document that public hospitals might be told to turn away non-emergency private patients if they are failing to meet their targets for public patients was condemned by the VHI. "This is not workable," said Mr Sheridan. "Private insurers must be in a position to deliver the benefits they contract for and need certainty with regard to the resources available to them and not have these resources subject to events completely outside their control."
The strategy document, Quality and Fairness, A Health System for You, promises that by the end of next year no adult public patient will have to wait longer than 12 months, and no child longer than six months, to commence treatment following out-patient referral. By the end of 2003, the target is that no adult will have to wait more than six months and no child more than three months. By the end of 2004, nobody should be waiting more than three months for treatment as a public patient.
To help reach these targets, a Treatment Purchase Fund will be set up to buy bed space and procedures from private hospitals, and, if necessary, to send patients abroad. Next year £25 million will be spent on this initiative.
The fund will pay for treatment in private hospitals here or in hospitals abroad. The strategy also promises medical cards for a wider range of people - although it does not say what the new income guidelines will be - thousands of community nursing places and more financial support for people caring for an older person at home.
Mr Finbarr Fitzpatrick, secretary general of the Irish Hospitals Consultants' Association, welcomed the strategy but said there was a need for 5,000 rather than 3,000 beds and that he was concerned there was no proposed reform of the health boards.
Tomorrow, the Government will publish its primary care plan.
Main Points
Hospital waiting times to be tackled, so that no patient has to wait linger than three months by the end of 2004
650 extra beds in acute hospitals next year, with another 2,350 to follow by 2011
National Primary Care Task Force to be established in January
Establishment of National Hospitals' Agency