Sir, – In the setting of the current budget discussions, (Arthur Beesley, Home News Analysis, October 10th) the expectation of further reductions in health care spending is ill- conceived and if executed raises the probability of health care rationing.
Health care rationing means that doctors will be forced to restrict treatments for patients based on financial constraints. With a €3 billion reduction in health care spending over the last few budgets, the emergence of health care rationing has not been recognised or acknowledged by the Irish public.
At this point Ireland spends less on health care per GDP than Greece, Portugal, UK and Germany. The Minister of Health, HSE and Department of Health are in an impossible position.
A tipping point will be reached and to further reduce health care funding can only lead to rationing. Furthermore, a blinkered focus on reducing expenditure also fails to recognise the need to invest in order to secure future cost efficiencies. For example, €3 million is required this year to support organ donation, which in turn will save the lives of Cystic Fibrosis patients and lead to savings of €61 million by reducing the dependence on kidney dialysis.
As a frontline worker, the optimal delivery of care in the current fiscal environment is challenging, and frustrating. Up to 10,000 staff members have left the HSE, yet the troika require a further drop in the numbers working in the organisation. To replace or reposition frontline staff is a major logistical challenge, frustrating efforts to bring about efficiencies.
Unlike the troika, health care workers are professionally and legally accountable. Health care efficiencies indeed are welcome and should be supported but the troika cannot expect us to extract Irish blood from a stone!
Prof JIM EGAN,
Consultant Respiratory
Physician,
Mater Misericordiae
Hospital, Dublin 7.
Sir, – The IMF's latest Fiscal Monitor Report (Business + Technology, October 10th) has implied that Ireland's top marginal tax rate (55 per cent) could be raised to almost 70 per cent while still maximising the potential return for the exchequer.
This appears to blow a hole in the argument constantly being made by some lobby groups for lower taxes for high earners.
The real problem in Ireland is that top rates kick in at extraordinarily low income levels, This should be addressed without increasing the overall tax take and, if the IMF is correct, without encountering the law of diminishing returns by raising marginal rates for high earners.
Giving more discretionary income to mid-income taxpayers would be far more beneficial to national morale and the domestic economy than lowering marginal tax rates for very high earners who, as it stands, benefit from much more moderate effective tax rates on the totality of their incomes. – Yours, etc,
BRIAN FLANAGAN,
Ardmeen Park,
Blackrock,
Co Dublin.
Sir, – Early in the week, Siptu leader Jack O’Connor was calling for pay increases across the economy, should the Government reduce the budget deficit by less than 5.1 per cent. Lo and behold, soon afterwards the Government announced it would be making a budget adjustment of €2.5 billion rather than the anticipated €3.1 billion.
This got me thinking. Had the Siptu leader that much influence? My more cynical side thought: perhaps he has a line of communication to the Economic Management Council that Government Ministers could only wish for? – Yours, etc,
JOHN BELLEW,
Paughanstown,
Dunleer,
Co Louth.