Sir, – It is clear that our healthcare system is not serving the people. Your correspondent Turlough O'Donnell (June 24th) rightly says that health insurance is paid largely by people of modest means because they have no faith in the public health system. However, there are a lot of people in Ireland who have little or no means. Are they to be denied good healthcare because of this?
Perhaps it is time that we improved the public health system and tried to restore confidence in it. All political parties should commit themselves to the principle of publicly funded universal healthcare, free at the point of access, where the only criterion for use is medical need. – Yours, etc,
PHILIP MORIARTY,
Shanowen Avenue,
Dublin 9.
Sir, – I note Turlough O’Donnell’s defence of the private healthcare sector (June 22nd). He states that “without the independent sector, the public health system would implode” and “the public sector needs to fix itself, with the resources that are currently at its disposal, and stop looking at others as the cause of its illness”.
I would certainly acknowledge that the “private healthcare is bad” narrative is both incorrect and does a disservice to the broader healthcare debate. But the perpetuation of a taxation-funded public healthcare system paralleled with the promotion of a private healthcare system is undoubtedly damaging to patients, population health and society at large.
It is wrong that some patients receive elective surgery within weeks, whilst others wait years; that some patients wait one day for a scan, when others never get one. To believe that this is wrong is to believe in equity, fairness and social solidarity; it is to believe in universal health care (UHC) where financial means should not affect ability to access services.
The Association of Independent Medical and Surgical Specialists’ belief that the public system, which is chronically underfunded, must “fix itself” first is incongruent with a belief in UHC. Primary and secondary care should be planned and delivered in a co-ordinated, integrated manner – not by permitting one part of the system to deliver care at the behest of the market. Yes, the private sector delivers care which is often excellent, by wonderful staff, in pleasant surroundings. But it undoubtedly cherry-picks more lucrative, lower-risk, elective care and procedures – dictated by market forces and not by social or health need.
Despite attacking Clare Conlon's assertion (June 21st) that private patients may receive care that they do not require, there is in fact compelling evidence that a fee-per-item system promotes over-investigation and over-treatment. Listen to the national radio; the Mater and Beacon private hospitals are busy advertising health screening (which lacks an evidence base), but I don't hear them advertise (or deliver) 24-hour emergency care services, stroke services or the extent of chronic or critical illness care that the public service provides. And why should they? The private sector is not bad – it is doing precisely what it is allowed to do.
If only we could debate the type of UHC our society should choose. Alas, the biggest ruse of all, which suits the Government and the private sector alike, is the conflation of UHC and universal health insurance (UHI) as equal concepts. – Yours, etc,
Dr MARK MURPHY,
Elmwood Avenue,
Ranelagh,
Dublin 6.