FOI material shows serious problems with private clinics plan
Issued : Sunday 20 May, 2007
When people go to the polls on Thursday they will be making a decision that will determine the future direction of public policy in a number of key areas. Nowhere will the decision be more important or the choice more stark than in the area of health.
We often hear complaints about what is perceived as the lack of major policy differences between the major parties in this country. I don’t think that this is true generally, but it is most certainly not true in the area of health.
The clear choice now facing the electorate in regard to health is to support the government’s plan for the further development of the two-tier system and the introduction of for-profit United States health care or to vote for the Alliance for Change and their plans for the strengthening and development of our health service for the benefit of all the public.
There are two quite distinct approaches on offer. The key component of the government’s health plan is the proposal to gift valuable sites and provide generous tax concessions to facilitate private developers to construct super-private clinics. The Alliance for Change, on the other hand, is committed to the provision of 2,300 additional public hospital beds and the provision of 1,500 step-down beds, including 600 in the Greater Dublin area.
The Harney/Ahern plan to build super-private clinics on scarce public lands, financed by generous tax concessions – tax reliefs now admitted by Mary Haney to cost around €180m – is a serious policy error. It is expensive, it is bad for patients and it is wrong. It is a backdoor route to a for-profit health system for which the government has no mandate.
With the dissolution of the Dail, we have not been able to get up-to-date information as to the status of the planned contracts for these super-private clinics. I understand that tenders were due to be submitted by Thursday last, May 17th and that a definite decision was then due to be made within two weeks of that date.
The Dail is not due to reconvene until June 14th and I think it would be unthinkable – regardless of the outcome of the government - if outgoing Ministers were to proceed with this plan before the election of a new government.
It is very clear that the plan for super-private clinics is driven the ideology of the Progressive Democrats. No proper estimates are available as to the potential cost of the plan and no assessment has been done of the impact of the plan on public hospitals or our existing private health insurance system.
We have received a number of documents obtained under the Freedom of Information Act* which show:
• A briefing note prepared for the Secretary General of the Department of Health on October 27th, 2005, warned that the loss of income for public hospitals was estimated to be €145m per annum. (Indeed this figure seems to actually understate the amount. In documents obtained by RTE this week under FOI the HSE said that the total charges levied by public hospitals on private insurance companies over a four year period amounted to €800m. In other words over the five year period of a government, the loss of income to the public hospital system would be greater than the cost of delivering 2,300 additional beds - €850m.)
• An internal Department of Finance memo dated October 3rd 2006 expressed concern about the possible implications of ‘losing experienced doctors, nurses etc from public system to private hospitals where working conditions and remuneration may be more favourable’.
• As recently as a January 18th last an internal Department of Finance memo concluded that ‘the transfer of 1000 beds from the public to the private system will impact on private health insurance costs as private hospitals will have to charge the full economic rate, including the need for a return on capital investment’.
• The same memo identified two other issues that needed to be addressed 1)’the opportunity costs of the land foregone – could it have been put to better us’ and 2) ‘Manpower issues – drain of experienced medical personnel from public system’.
It seems quite clear from these documents that there are a number of serious problems about the Harney/Ahern plan that the public have not been told about.
It seems in particular that there are very serious concerns about the possible implications of the loss of staff. At a time when the public health service is already experiencing difficulties in finding sufficient staff, the defection of doctors and nurses to these new private clinics could only lead to further problems in A&E units and longer waiting times for treatment.
It is very clear that the only people who will benefit from this plan are wealthy investors, whose only motivation is profit and who have no interest in meeting the health needs of the Irish people. This is a plan that must be stopped and it can be stopped by people voting for Labour candidates on Thursday next.
*The documents were obtained under the Freedom of Information Act, by a former British Labour MP, Max Madden, now resident in Ireland, who has taken a particular interest in this issue
