The REAL health ‘puzzle’ is why put off the inevitable?
ADMISSIONS of dysfunction, ongoing failures, budget overruns and a general air of disarray concerning the healthcare system are now so normalised that they hardly even register anymore with members of the public. On the left of us we have HSE chief Bernard Gloster predicting a budget overspend this year of about €1.5bn and another ‘guaranteed’ deficit of more or less the same for next year.
Just over two weeks after a delighted Michael McGrath introduced the first Fianna Fáil budget since that party ruined the country 15 years ago, Mr Gloster was on RTÉ telling anybody who wished to hear that the €22.5bn he’d received for health services for 2024 was ‘not adequate’ to properly keep the show on the road.
And then on the right of us we have Robert Watt, that straighttalking, no-nonsense secretary general of the Department of Health, the kind of top civil servant ideally placed and equipped to sort out this entire mess. Well, maybe not, but he did offer a diagnosis of the HSE to the Oireachtas health committee which is masterly for its lack of precision.
THERE is, he says, a ‘productivity puzzle’ in the health service and a varying range of performance across hospitals in areas like waiting lists. A kind of postcode lottery healthcare. And then in the middle, there are about 850,000 patients waiting to be seen at outpatient clinics or hospitals,
according to the National Treatment Purchase Fund. About 500,000 of those patients were left cooling their heels for longer than the maximum Sláintecare waiting times of 12 weeks.
HSE, in a marvellous example of stating the bleeding obvious, reckons the longer-than-anticipated waiting lists were due to a number of ‘drivers’ such as post-pandemic pent-up demand – as if such pentup demand shouldn’t have been anticipated following long periods during the plague when people were barred from hospitals and clinics.
Did the thousands of managers and planners and experts in the HSE not notice how Covid had impacted attendance and treatment numbers? And, if the answer to that is yes, did none of those geniuses say we’d better get ready for when all that ‘pent-up demand’ would present itself?
And then there’s the Government who believe that underfunding healthcare is the way to go, when all it does is ensure failure.
IT’S now perfectly clear that the HSE needed a budget increase of at least €2bn to even maintain services next year. That’s because of very obvious inflationary pressure that spiked energy prices and also helped to send medical costs soaring. Mr Gloster insists that only about a third of the projected €1.5bn overspend for 2023 is due to costs over which the HSE has any control.
The ridiculousness of the deliberately insufficient budget assigned to the HSE for next year was amplified by Mr Gloster at the Oireachtas Committee meeting. He told the committee: ‘But I’m not planning to deal with that deficit by cutting services.’
He’s going to carry on spending anyway, despite not having the financial wherewithal, and despite not being given the green light to do so arising from the allocation given him by the elected Government. So remind me again, who’s in charge of this country?
This has been an extraordinary, unforced error by a couldn’t-careless Government, that appears tired and resigned to a battering in the next general election.
Health Minister Stephen Donnelly fought for more money for the HSE, even telling Public Expenditure Minister Paschal Donohoe that he was ‘insane’ not to agree with him. But in the end, Donohoe won and Donnelly was turned away, tail neatly tucked between his legs.
Next summer the Government will concede the extra billions for healthcare to cover the enormous hole then emerging in the HSE accounts. Unfortunately, for them, they won’t get any of the credit they would have received if they’d provided those necessary funds from the very beginning.