Ending Health Inequality
Labour Party Manifesto 2020

Labour’s healthcare plan is one of our five policy commitments that must be at the core of any agreement with other parties in the next Dáil.

End The Healthcare Lottery

Labour will redirect health funding so that it is aligned to population medical need. We want to end the shame where Ireland is the only country in the European Union that still has a health system governed by market forces and ability to pay, with deep inequality between regions and a widespread lack of medical staff.

Similar hospitals serving similar sized catchment areas have very different staffing and resource levels. For example, University Hospital Limerick had face 40% more emergency in-patient cases than Beaumont Hospital, but UHL has nearly a thousand fewer full-time staff. Similar geographical differences arise in access to basic community health services, such as GPs, home help, nursing home care and physiotherapy, with counties such Kildare, Waterford and Wexford faring worst.

Labour will extend State Claims Agency cover to Section 38 and 39 bodies, to ensure that health and social care service providers who are mostly or fully funded by the HSE have their public liability insurance costs met by the State Claims Agency. This will significantly reduce their insurance premiums and free up more resources for frontline healthcare and disability services.

More Rural GPs

Labour will develop regional scholarships and other incentives, such as the practice manager subsidy and HSE locum relief scheme, to encourage graduates to practice in rural areas and disadvantaged urban areas. The primary care setting will provide administrative support, better equipment and other incentives to make the career of a rural GP more attractive and improve retention levels. We will also develop an elder care strategy. This will include making available new technology medical devices and remote access to medical consultation for people living in isolated areas.

In rural areas, a greater proportion of patients are elderly, leading to more complex and intensive patient engagements and a greater demand for house calls than would be expected in urban settings. Yet older GPs in rural areas are retiring and it is increasingly difficult to secure younger GPs to take up practice in rural areas. Labour’s measures will end this vicious cycle, and help to both recruit and retain more rural GPs over the next five years.

More GPs, Nurses And Other Medical Staff

We will train more GPs and invest in practices, so that every community has access to a doctor. Labour will expand the role of advanced nurse practitioners, physician associates and community pharmacists, to help fill the gap while additional GPs are being recruited. We will end the two-tier pay system for nurses and other medical professionals.

Having more staff in primary care centres will mean fewer people travelling to hospitals. That will reduce overcrowding and waiting times. Staffing will include nurses, home help workers, physiotherapists, occupational therapists and counsellors.

Support For Carers

Labour will support carers and implement a Carers Strategy and improve pay and conditions for those working in home help. We will start by increasing the Carer’s Allowance income disregard and increase the Carer’s Support Grant by €100.

Carers are now estimated to save the state €10 billion every year. Almost 2 in 3 carers are providing more than 100 hours of care per week. Yet over 70% of carers have no access to respite and are worried about not having enough money for the future. It’s time we cared for our carers.

Increase Disability Support

Labour’s vision is to build an Ireland where people with disabilities are empowered to live independent lives with control, choice and options. There are 643,131 people in Ireland living with a disability. Yet, 90% of the disability health budget goes to supporting 5% of the population living with disability, many in residential settings.

To achieve this, we will ensure that no one with a serious disability or long-term illness is without at least a GP Visit Card if not a Medical Card and we will increase investment in services that help prevent blindness or loss of hearing. In addition, Labour will further develop individualised budgeting for care services to give recipients more autonomy and choice, and we will increase funding for personal assistance services (including in educational settings) and housing adaptation grants. We will improve services for people with neurodiversity, including breaking down barriers to social inclusion and employment, as well as providing healthcare services.

Assessment And Early - Intervention For Children

Labour will redirect resources towards early intervention with young children who have disability and special needs, including neurodiversity, to reduce waiting times and to improve outcomes. This has been shown internationally to be more cost effective, as well as much better for children and their families. Some parents are currently waiting over 3 years for their child to be assessed and to access disability services, despite the critical importance of early interventions.

Mental Health

Labour will deliver on child and adolescent mental health services (CAHMS). We will redirect funding to the primary care centre, extend free-of-charge GP care to all under-18s and link more patients to non-medical sources of support within the community. According to Irish experts, over 90% of mental health needs can be successfully treated within a Primary Care setting, with less than 10% being referred to specialist community based mental health teams.

Ireland has one of the highest rates of mental health illness in Europe and a very high suicide rate among teenagers. This not only has a social cost, but also a real economic cost, estimated at over €8.2 billion a year. It would cost a fraction of this to invest in preventative and early intervention services. As a society, we must do everything in our power to prevent suicides and mental health illnesses. We must examine the root causes that lead so many young people to take their own lives or to engage in self-harm.

As part of Labour’s wider commitment to staff local primary care centres, CAMHS can be properly staffed in every area to deal with the wide range of mental health issues presenting among children and young people. This is the essential missing piece in so many parts of the country.

Sexual And Reproductive Healthcare

Labour will improve contraceptive consultations and screening for Sexually Transmitted Infections (STIs), particularly for at-risk groups, and pilot a scheme of mobile screenings in rural areas. We will make Pre- Exposure Prophylaxis (PrEP) more widely available to reverse the rise of HIV/AIDS.

In addition, Labour will ensure comprehensive free-of-charge reproductive healthcare is available for all, including long-term contraceptive options and will expand the definition of medical leave to include time off work for fertility treatment. The current proposal from Fine Gael is too restrictive, both by age and contraceptive option. We will also ensure every woman has access to sanitary products to end “period poverty”, for example expanding Labour- led initiatives at local government level.