Ictu calls for common waiting list for hospital treatment

The Irish Congress of Trade Unions (Ictu) is calling for the introduction of a common waiting list for treatment in hospitals, with no differentiation between public and private patients.

It also wants greater State investment in acute services and primary-care facilities.

In a briefing paper on healthcare, to be published today, Ictu also urges that medical card eligibility be expanded until 35-38 per cent of the population is covered.

It also proposes that GP visit cards, which cover medical consultations but not the cost of drugs, be converted into full medical cards. It says that ultimately the goal should be the provision of a free GP service for all.

The report urges that 400 additional hospital beds be provided each year up to 2013 and it argues that the National Treatment Purchase Fund is not the best way to use public money to address long waiting lists.

Ictu strongly criticises the Government's planned private hospital co-location plan, which it describes as "simplistic in the extreme".

It says that the initiative will not result in the freeing up of 1,000 beds in the public hospital system, as is claimed by the Government.

"Private hospitals cannot and do not provide the same level of care as in the public system. For example, private hospitals will not provide 24-hour A&E departments, as they would find the cost prohibitive when set against likely income."

It says that private hospitals would continue to "cherry-pick", while public hospitals would continue to provide more complex and costly services, including complicated surgical procedures and expensive, but life-saving, rehabilitation treatments.

"As you are not comparing like with like, you cannot possibly expect that 1,000 extra private beds in co-located private hospitals will automatically free up 1,000 public beds.

"What you can expect is that inequality in the health system will be further entrenched, with private care privileged over the public system.

"Some HSE statements suggest that private hospitals will not be allowed to 'cherry-pick' and will be obliged to take long-stay medical patients and A&E cases.

"It seems highly unlikely that private developers would agree to such a model, as it is unlikely to generate sufficient profit."

The Ictu report also calls for hospital consultants to be paid in the same way for all patients, public or private. It says that a combination of salary and fee for service would "eliminate current perverse incentives and the unfair, two-tier health system".

"It is imperative that a common waiting list be adopted across the health service, with no differentiation between public and private.

"This would help to end the spectre of two-tier care, with treatment delivered on the basis of need, not income. Equally, public money must not be used to support or develop private healthcare."

The report says that primary-care services remain "underdeveloped" in Ireland and that associated services, such as physiotherapy or speech and language therapy, "often do not exist, or are plagued by waiting lists".

It says that the primary-care strategy of 2001 sets out a clear plan, but this has not been implemented.

The Towards 2016 national agreement sets targets for specific numbers of primary-care teams over the coming years.

"However, uncertainty remains as to the available funding and, thus, the entire strategy remains in some doubt."

The report accepts that funding has tripled over the last decade, but it argues that the health budget also has to meet some "social spending" and take account of inflation and a growing population.