Support for Sláintecare needed to fix Irish healthcare system

Head to Head: Government’s short-term support for long-term plan is inexcusable

Year on year, more and more public money gets pumped into a deeply dysfunctional and inequitable health system, while more and more patients are lying on trolleys or dying while waiting for basic treatments.

Meanwhile, 46 per cent of Irish people are so fearful for themselves and their families that they take out private insurance which provides them little more than more prompt access to services for which they are already paying taxes.

Battling to cope, demoralised and overworked, many frontline staff go overseas to escape chaotic, unpleasant and increasingly stressful work situations.

Everything is connected – and much of it is broken. To fix part of the problem, we have to fix it all.


Sláintecare is a blueprint for an affordable, universal, single-tier healthcare system where all patients are treated promptly and effectively on the basis of medical needs, not ability to pay.

This may sound radical – but it’s actually not.

Most other European countries ensure that their residents can access decent health treatment that is free at the point of use. In the UK, for example, the NHS provision ensures that only about 10 per cent of the population chooses to take out private health insurance.

Cross-party committee

Sláintecare is the product of a unique cross-party Oireachtas Committee on the Future of Healthcare, which I had the honour to chair. It is to the Government's credit that it has now formally endorsed Sláintecare and adopted it as Government health policy with the publication of its outline implementation strategy.

But putting words into action is another matter.

It is now all of 15 months since Sláintecare was published, setting out a 10-year strategy of rolling reforms. Yet the Government has only now published its set of actions for the next three years – and its implementation strategy lacks firm timelines and funding commitments.

This short-term commitment to a long-term plan is inexcusable. For people to have confidence in the reform process, they need to start seeing and experiencing real changes in how our health system operates. This is especially true if we are to attract back our Irish trained health professionals to help lead the reform programme.

For patients, this means real action to tackle healthcare logjams, the intolerably long waiting lists for hospital and community services.

It also means reduced healthcare charges; Sláintecare provides for a new healthcare card to be extended to everyone on a phased basis over five years. It would give everyone access, free at the point of use, to all publicly funded health and social services, including GP visits, diagnostic treatments, mental health services and homecare.

Transitional fund

A transitional fund of €3 billion over the next six years is crucial to the success of Sláintecare. It is required to pay for new infrastructure such as more primary care centres with diagnostic facilities, the expansion of hospital facilities, the training of additional primary care staff and a proper ehealth system.

This investment must be viewed in the context of the existing €20 billion per year spend on Irish health. This is above average for a developed country – yet we have much poorer access to care.

The Minister for Health said yesterday that he is confident that the Government and the Minister for Finance are committed to additional funding through the Budget estimates process, but he has provided no detail on this.

With the Irish economy in recovery and State finances improving, the next few budgets present a once-in-a-decade opportunity for Ireland to change direction.

We can repeat the mistakes of the past and blow it all on tax cuts or we can decide to invest in our country and deliver a health service from which every one of us will benefit for generations to come.