No valid excuse for failure to fix Irish healthcare
Opinion:Everyone’s right to access treatment equally must be enshrined in law
The programme for government committed to ending the “unfair, unequal and inefficient two-tier health system” by introducing universal health insurance with equal access to care for all, with no discrimination between patients on the grounds of income or insurance status.
This is nothing less than a commitment to totally transform our health service.
So where are we at, almost 21 months on from the election of the Coalition? The Government established the implementation group on universal health insurance to develop a White Paper, due to be published at the end of the year, outlining the proposed changes. But there is little hope of it meeting this deadline.
It’s difficult to discuss the Government’s ideas when we cannot be sure what it is proposing.
Our healthcare system seems stuck in a time warp, with never-changing headlines about waiting lists and health insurance increases.
In the last two years, nothing has happened to change the reality that, in Ireland, although we all get sick not all of us can afford to. It is an accepted truth of Irish society that our healthcare system is broken, but little is being done to fix it.
And where are the voices of those relying on the healthcare system in the debate about reform? Today Amnesty International is delivering the signatures of more than 18,000 people across Ireland who want to see radical change – a system that guarantees equal access to healthcare regardless of ability to pay.
They are calling for human rights to be put at the centre of reform , for a legal guarantee of equal access to care, no matter who you are or what you can afford.
The Government has promised two major pieces of legislation under its reform plans, a Universal Primary Care Act and a Universal Health Insurance Act. Much of this legislation will relate to the design of our healthcare system, the infrastructure needed to support it and how we will finance it.
We believe it must also set out the foundational principle of a reformed Irish healthcare system – the delivery of appropriate, quality care and with access for all on an equal basis guaranteed in law.
Explicit incorporation of the right to health into legislation could be the engine that drives change across the health service, setting targets and criteria that would guide decisions about the design of the healthcare system.
We should look at some of the 63 countries that have used the right to health to frame legislative or constitutional change to deliver better services. Countries including Germany, Canada, Norway, Sweden, and some American states have used legislation to guarantee equality of access, to ensure greater accountability and to embed core principles like “reasonable access to health services without financial . . . barriers”.
There is no “one-size-fits-all” approach to healthcare, no single model from another country that can be used here.
But what many of these reforming governments have in common is that they took an imaginative and bold approach to fixing a broken system. They put the right to health first and worked from this to design a system that protects the people that need it. They understood that legislation can be used to bring the changes needed to deliver better outcomes for patients.
None of these changes happened overnight, or without a great deal of discussion. But in Ireland, the debate just isn’t happening. The Government’s focus has shifted from how to deliver universal healthcare to how to handle the latest media controversy or to juggling funds to minimise cutbacks.
The Government is either serious about universal healthcare or it is not. If it is, then the proposals for how this will be delivered and paid for need to be brought forward now. They should then be debated responsibly by all those involved in our healthcare system, conscious that the ultimate test must be whether they deliver for the people who use those services, and their right to accessible, affordable, quality healthcare.
Colm O’Gorman is executive director of Amnesty International Ireland