Sir, – The underlying and wholly inequitable principle governing access to healthcare is that the money in your pocket determines what, when, and how you will access care, not the severity of your clinical condition or the urgency of your required treatment or diagnostic tests. Until this principle is changed, poorer people will continue to languish (and die) on waiting lists and trolleys, and others will access treatment and diagnostic tests that they may not even need, with no external scrutiny in private medicine. The Government has demonstrated recently its reluctance to amend legislation in this area as to treat someone based on how sick she is would surely open the floodgates and upset the strange dynamic of a mixed public-private system which favours those with money.
A caring society should start with the principle of free healthcare, paid for through direct taxation, delivered on the basis of clinical need. We pay significant taxes, levies and insurance – far greater that in many other European countries – so why is healthcare so expensive here? The numbers paying health insurance premiums will presumably continue to decrease and insurance companies may decide the market is no longer profitable for their shareholders. So why not start again with a publicly funded system for all paid for by direct taxation; this would mean no more middle men and associated bureaucracy, such as insurance companies, HSE administration for medical cards, administration for patient accounts and debt collection in every hospital, and a host of other “layers”. The well-off could continue to use private hospitals. A vision for healthcare with equity for all, translated into policy and action. Why not? – Yours, etc,
CLAIRE CONLON,
Ballykilcline,
Kilglass,
Co Roscommon.
Sir, – Minister for Health James Reilly’s announcement that those who had their discretionary medical cards cancelled in the probity review were victims of “unintended consequences” is an attempt to trivialise the injustice perpetrated on them and is another example of HSE spin.
Dr Reilly seemed surprised at the extent of the collateral damage of these unintended consequences which induced mental, physical, medical and economic distress on these patients and their families. The fundamental reason for this disgraceful fiasco is that James Reilly, Minister of State Alex White and their officials refused to listen the many voices of patients, doctors and political colleagues who had flagged over the past several months the very obvious consequences of this desperate probity review process.
The probity process went into overdrive since the last budget when the HSE was instructed to save as much money as possible by culling medical card numbers in a desperate attempt to balance the HSE fantasy budget.
Mr White explained the cull by stating “it’s the law”. Dr Reilly explained that there was no change in eligibility criteria and that the culling was legitimate and above board.
It is a sad commentary on our Government that it is the loss of votes in the recent elections rather than health needs of our people which has brought about this reversal in policy. So much for proper health planning.
Dr Reilly and Mr White should reflect on their arrogant inability to listen to sound advice in the short time that they remain in office.
Meanwhile the rest of the health service creaks and groans like a doomed ship. – Yours, etc,
Dr MICHAEL HARTY,
Kilmihil,
Co Clare.