Beyond giveaway highlights lurks long waiting lists, rising demand and recruitment issues
HEALTH consumers were particularly hit in the austerity years with outof-pocket expenses. They faced higher medical card prescription charges after they were promised they would be abolished. And for a long time there was little reprieve in the limit private patients had to pay for their medicine bills every month.
So after all the hardship most people will be glad to hear they have to shell out a little less cash – even if they have to wait until next summer and autumn for it to come through. It’s still modest, of course. Yesterday’s Budget cut of 50c in the prescription charge for all medical card holders goes further than expected as it was forecasted to be confined to the over-70s.
Private patients who use the Drug Payment Scheme and reach the current limit of €124 a month will be €10 a month better off from July.
It will create a “feel-good” factor which the Fine Gael Government hopes will carry it through when it promotes itself to the electorate in the run-up to the next general election.
The same “family friendly” theme sees the promise of free GP care for children under eight and free dental care for the under-sixes.
There are many hurdles to be crossed yet, including agreeing fees with GPs and dentists, and it is not surprising their respective unions were talking tough, as usual, yesterday.
Beyond the giveaway highlights of the Budget for the health service yesterday lurk the ongoing bottlenecks that continue to haunt it daily.
The health budget has been setting new records annually in recent years but the increases in funding have continued to be outpaced by demands.
This was seen starkly this year in the escalating numbers of people on outpatient waiting lists, the growing queues of people needing homecare and the failure to meet the four-week deadline for older people who are approved for nursing home support under the Fair Deal scheme.
There is also the hidden impact of what the HSE does not want to call an employment “embargo” but is leading to hospital groups and community services being told they cannot breach their hiring budget.
Health service unions issued predictable reactions to the Budget yesterday about the failure to attract staff, including consultants, due to pay and conditions.
But although they make valid points, at some stage they may also have to take some of the responsibility for adding to the negativity that may be driving workers away and contributing to vacancies.
The next round of pay talks is expected to be around closing the gap which sees consultants hired since 2012 earn €50,000 less than those recruited before that date.
It will be a test of the Government to see if the pay deal comes with reform.
It is also up to the new board and higher management in the HSE to stop looking for easy targets – like homecare and nursing home funding – to manage its budget.
The board has sat several times since early summer, but it has little to boast about yet, except a reduced deficit.
For the 560,000 public patients on outpatient lists and scores of others needing surgery there is some hope that the €100m to pay for some of their care privately will finally rescue some from deteriorating health. Some €75m was allocated this year but the target to stabilise outpatient waiting lists will not be met.
There is €20m towards a Sláintecare integration fund and €12m for care redesign to build up community services.
It is the way to go but, so far, the progress has been extremely slow.