Sláintecare – spend in order to save

Sir, – I was interested to read Pat Leahy's interview with An Taoiseach (News, September 18th). However, Mr Varadkar's comments in respect of Sláintecare require some clarification.

Sláintecare, which has cross-party support, sets out a plan for the introduction of a modern universal, public health system, comparable to that available in most other EU states. It proposes a lower-cost model of care where most care would be provided locally at community and primary-care level. It is estimated that to bring about this kind of accessible healthcare system would require an additional €400 million each year, on top of what would ordinarily be provided. This would fund the necessary extra capacity in primary care (GPs, nurses, therapists, etc), enable people to access care quicker and take pressure off hospitals. It would also allow the gradual reduction in user-charges that create such a barrier to accessing healthcare.

Separately, it is recognised that there was huge capital underinvestment in health over the austerity years. Things like primary care centres, ICT, diagnostics and hospital facilities were starved of funding. Sláintecare proposes a once-off, catch-up capital investment programme of €3 billion over the next six years.

The cross-party committee of TDs which produced the Slántecare plan clearly recognised that to continue with our current dysfunctional health system was not sustainable, on either economic or equity grounds.


Central to our plan is the need to ensure better value for money and better accountability across the board. That is why we call on Government to legislate for far greater accountability from the Minister down to staff at all levels, as well as legislating for national standards in clinical governance covering all clinical staff.

Last year the Dáil voted unanimously in favour of a universal single-tier health service where people would be treated on the basis of health need, rather than ability to pay. The Committee on the Future of Healthcare was tasked with setting out the fundamental reform and reorganisation necessary to bring that about. We were very conscious that reform costs money to achieve, but ultimately, if done right, it saves people money in their pockets, brings savings for the State and achieves better health outcomes.

The approach in Sláintecare is to spend in order to save, by a radical shift in the way services are provided. If as a country we have the courage and foresight to do that, the committee believes that we can achieve an effective, equitable and efficient health service. Tinkering with our current dysfunctional two-tier health system is no longer an option. – Yours, etc,


(Chairwoman of

the Committee on

the Future of Healthcare,

June 2016 to May 2017),

Dáil Éireann, Dublin 2.