The Government is failing to secure value for money and more efficient medical services in return for the funding it has lavished on the health system. If you are a public patient, it takes 18 months to see a consultant neurologist.
And children have to wait for years for vital psychiatric assessments or for orthodontic appointments. Necessary reforms have become bogged down in negotiations or are moving at a snail's pace within the social partnership process. In such a context, details of increased spending on some services, provided yesterday by Minister for Health Mary Harney, could be confused for pre-election window dressing.
Two-thirds of the additional funding will be devoted to the needs of the elderly. Specifically, the money will be used to keep them out of expensive nursing homes by providing a range of support services within the community. The development is to be welcomed as a benefit to the individuals concerned and to their families. As for nursing homes, a statutory inspectorate will be established and funded next year to monitor quality of care.
Having provided a spoonful of sugar in one area, Ms Harney may administer corrective medicine in another by announcing a new system of nursing home charges. With a rapidly ageing population, the Government is anxious to keep costs down. The level of State subvention for residents in private homes already varies widely in different parts of the country. Reform in that area is likely to be accompanied by new charges for public nursing homes, involving people with personal wealth or property. This could operate through home equity release or deferred payment schemes. But the Minister has offered assurances that nobody will be forced to sell a principal residence to pay for necessary care.
We have a poor record in caring for the sick and the elderly. And our hospitals and specialist services are failing to cope with demand. Five years ago, the Government pledged to end hospital waiting lists, to provide 2,000 extra beds and to issue an additional 200,000 full medical cards. They were ambitious objectives. But they haven't been achieved. And while Ms Harney insists we are well on the way to a world-class healthcare system, the reality is otherwise. Our citizens endure one of the poorest-quality healthcare systems in Europe and we have the second highest rate of poverty among the elderly.
Direct access to medical specialists along with the separation of public and private medicine have been identified in other countries as necessary ingredients in the elimination of waiting lists and the provision of quality care. But medical consultants here, who enjoy lucrative public/private contracts, are resisting change. Negotiations are at a standstill. And necessary reforms and service developments have been delayed. Expensive hospital equipment is still under-utilised. And nurses are threatening industrial action. These are complex and separate issues. But they are part of the bigger healthcare picture.