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  • irishtimes.com - Posted: October 17, 2008 @ 11:37 am

    The Silver Revolution

    Harry McGee

    RTE broadcast a documentary in the past few weeks about Ireland’s student ‘revolutionaries’ of the late 1960s. Once they finished university, three of the four (Ruairi Quinn, Una Claffey and Kevin Myers)  began a journey that is all too familiar in the west… from left wing to centre (and to the right in once case) and from outsiders to pillars of the establishment. Anyone who flicked through at the CVs of the New Labour frontbench during Tony Blair’s first two terms would have discovered a rag bag of communists, hard-left student politics leaders, Marxists and Trotskyite (Jack Straw, John Reid, David Blunkett etc) who had back-flipped totally.

    The Budget-day decision on Over 70s medical card  has proved to be a fiasco. The idea to introduce cards was a noble idea. The problem is that the then Finance Minister Charlie McCreevy (him again! All of his chickens are now coming home to roost!) didn’t bother consulting with doctors before introducing it. That was a big mistake. The medical profession as an interest group is hard-core… just look at the marathon hold out over a new contract by vastly over-paid consultantans. They knew they had their hand on the tiller when it came to the hard-chaw negotiations.

    The IMO went in and got a golden deal for GPs and a lousy deal for the taxpayer.  Just look at the math. For over 70s, there are two ways of getting a medical card. If you already have a medical card – or qualify for one on grounds of pay – you keep it. That accounts for the bulk of pensioners – 215,000. For each medical card, the GP gets paid a flat fee of €161 a year.

    However, the new medical card (an additional 140,000 people over 70 qualified for it irrespective of means) was of a different order. GPs got paid an annual fee of €640 for every one, over four times higher than the means-tested medical card.

    There was a grotesque imbalance here. The 215,000 who were actually entitled to a medical card cost the State €161 each per year while the 140,000 who qualified on age grounds cost the State €640.

    Essentially GPs made a lot of money out of this scheme. There was a doctor on Joe Duffy (who wasn’t challenged by Duffy) who said that his practice had expanded from five doctors to seven, from one nurse to two or three, and from two secretaries to five in the interim. In other words, he was saying he invested the extra money in his practice. That’s not a justification. If he expanded his practise, he expanded his income. Sure if I got an extra €30,000 a year from my employer, chances are that I would invest it in building an extension to the house to accommodate a snazzy office.

    Cleary there was an inequity at the heart of it that had to be tackled. The likes of  Tony O’Reilly having a medical card is almost preposterous.

    But the Government’s decision showed that Fianna Fail’s boast of staying close to the heartbeat of ordinary people has deserted it. The announcement was flagged in the run-up to the Budget but was done in a cack-handed way. Pensioners everywhere panicked, irrespective of whether they were losing the card or not. The communications was abysmal. Fianna Fail TDs were not briefed for 24 hours. There was uncertainty over who would keep the card and over who would lose it. The Governmen took two days to pony up the thresholds.

    By that time the damage was done. The chat shows and phone shows were over it like a plague. How did the Government not know, for godssake. Joe Duffy ran with the medical card story EVEN BEFORE  theBudget was announced. And it was only when FF TDs started getting swamped with calls (one man told his TD that he was going to kill himself – that’s how emotional it was) that the Government started to act.

    Last night’s clarification on thresholds was being played as a bit of a climbdown. But the story is not going to rest there. I’d say that FF TDs will get in their ear at their constituency clinics this weekend and this controversy – people-led- will rumble on for weeks.

    The inequity of the system needs to be tackled. The Government will just have to break the contract and tell GPs they can no longer get €640 per patient. But to do it in a way where over 70s don’t lose out. There are working class areas without proper GP cover now. The reason for that is simple. Doctors won’t get there when they know that the over 70s there will be worth only €161 to them. Much better to go to more affluent middle class areas where they will be guaranteed a glut of patients in the €640 class.

    And make no mistake about it, this is people red. Revolution and reactionary tactics are not just the tactic for  protected university students.

    • red mum says:

      ‘Cackhanded’ is the best way to describe this whole debacle. I have to say though the way in which older people have put this (one of many savage measures hitting seriously vulnerable people) firmly at the top of every agenda is seriously impressive. And that’s without mass organisation…

    • Dan Sullivan says:

      Older people, and go to meetings and do all the old school social pressuring that too many people under 40 aren’t interested/comfortable with doing.

      I can’t help seeing that the retreat of FF ministers from as much direct engagement as they had in the past with the grassroots has had some small effect here. Fewer local cllrs, no more conventions, 1/3 of constituencies in 2007 had Dail candidates selected by HQ not convention. Many of the ministers have been in situ for well over a decade, and appear to be believe (and with some cause) that no matter how they screw up they won’t be cast out.

      I said it here http://sluggerotoole.com/index.php/weblog/comments/post-budget-reaction/ but it bears repeating (or so I think :-) )

      “The drip-drip impact of these announcements will resonate far beyond budget day itself. And the daily reminders of increased charges like A&E access of €100. June 12th next year might even see students who are faced with the €1500 registration charge actually get out and vote for once. Add on top of this the mergers of the various quangos/state agencies and the attendant reduction in services and you’ve got a possible death by a thousand cuts. “

    • Harry says:

      Amazing goings-on over the medical card today around Leinster Housel. Two of the independent TDs were in with Harney for an hour and a half today. Mary Coughlan also complaining today that FF TDs should not be speaking outside of school even though most have now broker cover. I’ll be very surprised if there is no compromise. Fine Gael, Labour and SF have all upped the ante…

    • Ray D says:

      Amazing how Labour has jumped on the bandwagon – very late in the day mind you – in relation to the medical card. Surely what the Govt has done is classic Labour Party policy?

    • Dan Sullivan says:

      It would seem it is all going to hell in a handbasket faster than it takes a terribly fast thing to traverse an incredibly short distance, in a vacuum, with the assistance of a strong tailwind.

      I believe that the minimal upshot of this to be Harney’s departure from Cabinet and the Dail. After defending the measure to the hilt it is utterly untenable for her to remain as minister after the Cabinet would have deserted her.

      Of course, this could all be a profoundly cynical means to jettison the PDs and allow the Government to reveal its kinder gentler side but I’m more than likely reading way, way too much into it all.

    • Robert Browne says:

      Mary Harney has and is completely ineffectual in her so called “poisoned-chalice” post of Minister for Health. If she was in the private sector she would be fired without batting an eyelid. The only reason she has remained in the job so long has more to do with her huge ego which she carefully disguises with her Reverend Mother demeanour. Now, match that carefully-cultivated image up with cervical cancer vaccines being withdrawn as a money-saving exercise and old-age pensioners being targetted and you start to see the real person revealed. She has become a complete parody of her former self. I am 50 years of age and in my life I have never seen anyone become so deluded about their role in Irish life! She should go before more people die and she should not receive a penny in pension money, which should be performance-related for all retired ministers.

    • Silver Revolution. UK Jonathan Silver is founder of Electric Transport & Electric Revolution in UK. US Jonathan Silver is Washington in charge of the funds to be invested in US alternative transport & energy. This is a positive Silver Revolution.


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