Sir, – Jim O’Sullivan criticises private businesses, saying that “the evidence is everywhere” that they “prioritise self-interest and not the provision of service” (Letters, July 22nd). Healthcare is listed as one of his examples. The compelling evidence is that the opposite is true and that it is well-funded public services that underdeliver, overwhelmingly.
For example, Irish public health expenditure, correctly measured as a percentage of modified gross national income, is a top spender in OECD public health spending tables. Every single year billions of euro are added to the annual public health budget and many thousands of additional staff are recruited. The staggering increases in public health spending every year indicate the desire on the part of Government to deliver strong public health services for citizens, but the system refuses to enable the provision of even adequate service. This year the state will spend over €21 billion on public health, up €6 billion in just four years. The annual increases in Irish public health expenditure are way beyond our peers and every year the number of people employed in our public health system increases by many thousands. Have we noticed a demonstrable improvement in health services delivered to citizens? The Irish Fiscal Advisory Council (IFAC) has laid bare the facts about Irish public health provision. IFAC shows the massive spending, putting Ireland in the top bracket of OECD public health spenders, and concluding that “Ireland’s public health spending is high relative to its peers”. However, poor planning controls and delivery by the health service mean that citizens observe and experience massive waiting lists and a litany of negative outcomes. IFAC shows that health spending is Ireland has risen quickly by international standards despite favourable demographics, ie a younger age profile in our population. We now have well in excess of circa 130,000 public sector employees in our healthcare system; one in every 28 adults in Ireland. Ireland’s citizens by and large receive poor service provision from the public health system, despite it being very well funded, largely by multinational companies and highly progressive personal taxation on higher earners. Until management and unions in the public health system truly embrace and drive the reform that is required in the provision of public health, services to citizens will continue to cost more and underdeliver. – Yours, etc,
MARK MOHAN,
Castleknock,
Dublin 15.