The Irish Times view on the Sláintecare plan: a strategy that needs a budget

Once again, the Government has weakened a health strategy by failing to specify how it will fund its proposals

The Government has not revealed how much it will cost to implement its 10-year plan to reform the Irish healthcare system.

 

The Publication of the Sláintecare implementation strategy provides a framework to advance much-needed reform of our health system.

Launched in May 2017, the all-party 10-year Sláintecare report was costed at €2.6 billion plus a once-off capital spend of €3 billion. However there had been little progress until the recent appointments of Laura Magahy and Tom Keane to head up the Sláintecare Programme Office and its Advisory Council. Specific actions listed in yesterday’s strategy include implementing a new GP contract, investment in eHealth, tackling long waiting lists by investing in the National Treatment Purchase Fund and increasing bed capacity in public hospitals.

With high levels of dissatisfaction with ever-increasing waiting times to see hospital consultants and to have necessary investigations and procedures performed, one element stands out. The report contains a commitment to examine the introduction of legislation for an “evidence-based waiting lists guarantee”. This would be a commitment in law that no patient should wait over a certain period of time for procedures. A radical move but one with a large enough stick that might just move us beyond the shoulder-shrugging that has become a default response to the issue.

However, once again, the Government has weakened a health strategy by failing to specify how it will fund its proposals. Whether transition funding will be made available to ensure the immense change process is resourced remains unclear. Other than a commitment to capital expenditure, Minister for Health Simon Harris was unable to specify costings for the actions listed in the plan, and the Department of Finance is on record as saying there will be no separate funding for Sláintecare, with money coming instead out of the regular health budget.

Furthermore, Minister for Finance Paschal Donohoe is thought to be lukewarm about Sláintecare. And despite a short statement of support, the absence of the Taoiseach at the launch event could be construed as a less than stellar endorsement of his health minister’s undoubted enthusiasm and commitment. Sláintecare is the last chance saloon for our dysfunctional public health system. Not alone does it require the enthusiastic backing of those currently in power, it requires all-party commitment from those who may themselves assume the levers of government at some point during the plan’s 10-year timeframe.

Harris acknowledged that many health professionals are suffering from “reform fatigue”. But they, too, must rally around Sláintecare. The Republic is an exception in Europe in having a health system that is based on an ability to pay rather than clinical need. It is neither fair nor equitable. Properly funded, Sláintecare can reverse this fundamental anomaly.

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