Overflowing hospitals, traffic mayhem, unsafe water and shambolic schoolsprovided the backdrop to this week's publication of the Estimates. And nowwe're told it's only going to get worse, writes Fintan O'Toole
Here is a snapshot of the Republic of Ireland yesterday morning, as citizens were digesting the news of harsh cutbacks in public spending. One of Dublin's biggest hospitals, the Mater, announced that it was shutting up shop and taking no more admissions because it simply couldn't cope. There were 18 patients on trolleys in the Accident and Emergency department and the surgical ward was also full of A&E patients.
Commuters, exhausted after one of the worst ever traffic snarl-ups as they tried to get home the previous night, were finding many roads impassable because, in a shocking and completely unpredictable development, there was heavy rain in Ireland.
With water, water everywhere, dozens of families in Co Wicklow had not a drop to drink because the wells were polluted. The Department of the Environment was studying a ruling from the European Court of Justice the day before that group water schemes are so polluted that they fall below acceptable minimal standards, and must be upgraded.
Thousands of primary school kids - assuming they could get to school at all - were sitting in buildings that the then Minister for Education, Michael Woods, admitted last April are unsafe and pose a health and safety risk. Among them, for example, is St Mary's National School in Aughamore, near Ballyhaunis, Co Mayo, which had to close for a week last April because it was infested with rats.
These were just some of the more obvious features of the shambolic state of public services in one of the world's richest economies. Charlie McCreevy's Estimates were essentially a statement that none of these things are going to get better.
The Estimates mark an explicit abandonment of the National Health Strategy that is supposed to make the barbaric conditions at a hospital like the Mater a thing of the past.
The infrastructural development that might allow for a rational mix between private and public transport is being brought to a virtual halt.
The Local Government Fund, which ought to provide money for the kind of drainage schemes that would prevent much of the flooding that makes people's lives a misery, is being cut by an effective five per cent. In real terms, there is a 14 per cent cut in the money available for sewage and water treatment facilities, so thousands of people will just have to go on drinking polluted water.
The capital budget for primary school buildings is being slashed by almost 25 per cent, so many primary school kids will continue to have not just a nature table in the classroom, but a whole ecosystem, with rats and fungi a speciality.
All of this carries a high human cost, ranging from the severe inconvenience of ridiculously long commuting times to the outright degradation of old people who have paid their taxes all their lives being denied even basic privacy when they are sick and distressed. But it is also very bad economics.
The economic cost of a failure to invest in public transport is obvious enough. Gridlock has a real effect on the real economy. Last August, for example, the Small Firms Association published the results of a comparative study of the time taken for a simple business trip in various cities around the world. It tested the time taken for 5kg of goods to travel 5km. In Singapore, the journey took nine minutes. In London, the average journey time was 13 minutes. In Amsterdam, Paris and Helsinki, it took a quarter of an hour or less for the goods to reach their destination. In New York, it was 17.5 minutes. Bombay was bad: 37 minutes. In Dublin, however, it took an average of 57 minutes. The only city that was worse was Calcutta.
These were average figures, but in the morning rush hour in Dublin the average delivery time was an hour and 20 minutes. According to the Small Firms Association, all of this "impacts on business by increasing travel-to-work times, exacerbating the bottlenecks in the movement of goods and eroding the competitive edge of business".
So what is Charlie McCreevy doing? Delaying the LUAS. Essentially abandoning the Metro. Forcing bus fares to rise by refusing to subsidise public transport in a manner comparable to any other European city. Even in strictly economic terms, all this means higher costs for business, more difficulty in attracting investment, higher inflation, and probably in the medium term, more damage to the public finances because less revenue will be generated.
This is obvious enough. Less so is the cost of not implementing the National Health Strategy.
Take, for example, yesterday's closure of the Mater hospital. The main reason why the hospital is full is because 94 beds are occupied by patients who have actually been discharged by their consultants. They are medically fit and do not need to be in an acute hospital. So why are they there?
Because they are old and frail and can't simply be sent home. They need to go to nursing homes or into sheltered community care. Nursing homes and community facilities are far cheaper than acute hospitals. But the abandonment of the health strategy means that we're not going to invest in the creation of an adequate number of nursing home beds. So we'll waste vast amounts of money, gum up the hospital system, and inflict completely unnecessary misery on vulnerable citizens.
And why are there so many people in the A&E departments that a major hospital has to announce that it won't take anyone in unless they arrive in an ambulance?
Partly because many people who could be treated just as well and in far more comfort by their local GP can't afford to visit the doctor.
Hundreds of thousands of people on low incomes no longer qualify for a Medical Card. They also can't afford VHI. So they either wait until a fairly minor illness becomes a major crisis and they end up in casualty, or they go to casualty anyway, because it's cheaper.
And what does Charlie McCreevy do? He abandons a very specific commitment in the Fianna Fáil election manifesto to extend the Medical Card scheme to 200,000 people on low incomes. And he raises the thresholds for the Drug Refund Scheme, so that prescriptions will cost these people more.
The outcome is entirely predictable: the hospital crisis will get even worse, even more people will flood the A&E departments, and the taxpayer will be paying a fortune to treat people in acute hospitals, rather than a modest amount to have them treated by GPs.
If all of this suggests a complete absence of basic logic, there is one sense in which the strategy is consistent and coherent. The weakest will pay the heaviest price. For all his tough-guy talk about making hard choices, Charlie McCreevy has never shown any inclination to pick on anyone his own size. Taking on the wealthy and powerful who get away with the most outrageous evasions of social responsibility would be brave. Taking on the sick and the homeless isn't.
On Morning Ireland yesterday morning, Charlie McCreevy defended himself against the charge of adding to inequalities in Irish society by citing a speech earlier this week by Prof Brian Nolan, of the ESRI. This, he claimed, proved his critics wrong. It actually does nothing of the sort.
What Prof Nolan said, on the basis of the latest figures from ESRI income surveys, was that the boom had not exacerbated the gap between rich and poor. In 1987, he pointed out, the top 10 per cent of full-time employees earned 3.6 times more in gross weekly pay than the bottom 10 per cent. In 2000, the figure had dropped to 3.3 times.
In claiming vindication, Charlie McCreevy conveniently ignored the fact that these figures refer to gross pay. They do not, therefore, take account of net pay, in other words, of the effects of tax cuts in McCreevy's own budgets.
In his budgets between 1998 and 2001, the vast majority (90 per cent) of the additional resources went to tax cuts. The social welfare budget actually lost three per cent. The effect was that the bottom 20 per cent of people had their incomes boosted by little over one per cent by McCreevy's decisions, while the top 20 per cent gained close to three per cent.
This is the background against which the Estimates have to be understood. Coming off the greatest boom in our history, the Republic was ranked 16th out of 17 rich countries in the recent UN Human Development Report. This is exactly the same ranking we had in 1997. We still have 200,000 people living on less than €173 a week. We still have 23 per cent of the adult population functionally illiterate. The lowest social welfare rate is still €118. 80 a week - nearly €40 below the official poverty line.
This very week it was announced that the number of applicants seeking local authority housing had increased by a quarter in the past three years and was now up to 50,000 households. Yet the Estimates suggests that perhaps 20 per cent fewer local authority houses will be built next year. This is 20 per cent fewer than the hopelessly inadequate figure of 4,875 built in the year 2001, the last for which we have statistics. The result is very obvious: more homeless families.
The point of all of this is to maintain, at all costs, a low-tax regime, especially for the well-off. The choice that has been made is very clear: protect the winners of the boom at the expense of the losers.