The health service emerged as one of the top concerns of voters in the general election. And just as the body politic must find an innovative solution to the formation of a government, it must also acknowledge a damaging lack of vision for our health system.
With a current annual spend of some €13.2 billion, the health budget has recovered from savage cuts. But the effects of indiscriminate financial surgery remain: doctors and nurses reluctant to work in a dangerously overstretched system; patients languishing on hospital trolleys; and a poorly resourced primary care sector that is unable to look after a population with an increasing prevalence of chronic disease.
The National Association of General Practitioners (NAGP), the Irish Nurses and Midwives Organisation (INMO) and a number of respected commentators have noted both a need and an opportunity for health reform. "With such a divided electoral result, differing and competing health priorities by all the [POLITICAL] parties, and no consensus on how to improve our fragmented health system, there is a need to consider a new approach to health care," the NAGP says.
It proposes a 10-year “Tallaght Strategy for Health” which it believes would create direction and stability similar to the 1987 initiative of the same name which is credited with prioritising the national interest ahead of political gain. Such a plan would involve a negotiated consensus on the part of patients, stakeholders and politicians with the aim of depoliticising health.
The INMO, for its part, has reiterated a call for a national health summit, observing that no service that is fit for purpose “can be developed, and sustained while existing within the five year electoral cycle and in the absence of consensus”. It envisages such a summit being fully inclusive and not confined to political parties. The organisation wants current practices, structures and funding reviewed and debated.
An alternative approach was put forward during the election campaign by the Social Democrats who suggested that a Dáil committee should conduct an all-party inquiry into the system.
It is abundantly clear that the status quo cannot remain. Health reform driven by a five-year electoral cycle cannot deliver sustainable change. There is a need to put patients first with health care delivery focused on them and their families. This requires a properly integrated and balanced system whereby primary and secondary care are knitted together to provide people with a seamless journey through illness.
Time and energy must be invested in creating a system based on providing care that is free at the point of delivery and driven by medical need rather than political expediency. Nothing short of a depoliticised national health forum will deliver on this shared national imperative.