The party says it will review medical card eligibility for people with long-term illnesses, writes Dr Muiris Houston
Not surprisingly, the Progressive Democrats' health manifesto is largely based on last November's Government Health Strategy. In recommitting itself to the strategy, it says it will place emphasis on:
a) ending waiting lists for hospital treatments;
b) expanding primary health care teams for more services in the community;
c) extending services for people with intellectual disabilities;
d) extending care for older people, including the expansion of after-hospital care and
e) using the private sector to contract for public health services.
The manifesto specifically mentions the need for an "early and clear report" on health management structures. The party says this will be carried out and a report published by the end of 2002. Sources have confirmed this is aimed at flushing out poorly performing management in the health boards. It also recognises that to speed up the delivery of services following additional investment, management structures need to be "retuned" to delivering quality care at the front line. The party has also committed the Central Statistics Office to publishing quarterly reports on health service activity.
In a rejection of Labour Party proposals for an insurance-based system built on universal patient registration, the manifesto says "our complex health system cannot be changed overnight". It says any benefits would be "outweighed by the risks of confusion and disruption to the population".
The party believes the mixed funding of our health services should not be tampered with. It wants the public sector to be more a buyer of services for patients than a "buyer and provider of services". It has signalled a greater commitment to the Treatment Purchase Fund - through which public patients will be treated privately or abroad - by committing itself to a tenfold increase in the fund over five years.
The manifesto contains a ringing endorsement of primary health care, calling it "one of the best features of our health service". Referring to the new primary care teams outlined in the Health Strategy 2001, it says "we will implement these new teams with determination, accelerating the roll out across regions".
PD policy on medical cards is clearly stated. "We do not support a dilution of the social policy objective of the medical card scheme by giving the medical card to all, irrespective of need. It is not a priority for the Progressive Democrats to give free GP services to people who can afford to pay for them."
However, it makes a proposal on the long-term illness scheme, under which people with certain chronic illnesses receive free medication and appliances. It will review medical card eligibility for people with long-term illness.
Sources have also confirmed the party will undertake a regular review of the illnesses covered by the scheme, which could be good news for people with asthma and other illnesses who do not benefit.
However, the party shows it is not above parish-pump politics in its proposals for cancer care centres for the regions. While no one will argue that "there is an urgent need to implement centres of excellence for cancer care across the regions", its opinion that the views of local people must be taken into account in siting these centres suggests the possibility of a radiotherapy unit in every city.
There is a need for a proper hub and spoke model for cancer care in the Republic, but the PDs will be a long time coming up with the scientific evidence to back up large-scale regional largesse.