HEALTH PLAN WILL COST ‘BILLIONS EXTRA’
After the Mail first raised warnings, medics doubt Sláintecare costings
THE all-party plan to finally give the people of Ireland a health service we deserve will cost taxpayers billions more than is claimed, senior consultants have said.
Their analysis comes after the Irish Daily Mail was first to raise concerns over the costings outlined for Sláintecare, when it was launched last June.
At the time, it was envisaged that the running costs for the myriad health reforms would come to €2.8billion in phased payments over ten years. However, preliminary analysis by this paper showed the true cost would be in the region of an extra €2.8billion for every year, on top of current health spending. This would add up €28billion over a decade.
And now, in its submission to the Sláintecare Independent Review Group, the Irish Hospital Consultants Association argues that the actual running costs of the 23 Sláintecare proposals will eventually come to ten times the committee’s claim, costing €20billion for the first decade, with the cost increasing to €28billion plus inflation in subsequent decades.
Sláintecare is a ten-year plan for health, created by a cross-party committee that sets out a reform agenda that would involve, among other things, introducing universal free GP care and stripping private care from public hospitals.
However, the IHCA called the cost estimates in the plan a ‘gross underestimate’ of the real costs.
Association president Dr Tom Ryan said: ‘It is absolutely astonishing that the Sláintecare report contains an underestimation of such magnitude.’
Among the reform measures set out in the plan are: ÷Removal of inpatient charges for public hospital care; ÷Reduction of the prescription charge for medical card holders from €2.50 to €1.50; ÷Removal of the Emergency Department charge; ÷Disentanglement of public and private health care financing in acute hospitals and removal of the ability of private insurance to fund private care in public hospital.
The committee also said there would be a €3billion once-off cost to set up the changes.
Dr Ryan said the proposal to remove private practice income from public hospitals alone would cost public hospitals in the region of €6.5billion over ten years.
‘When adjusted for inflation the estimated cost will be in the region of €8billion per decade, which is €800million in lost hospital income per year,’ he said.
However, responding to the criticism, Sláintecare’s chief architect, Social Democrats TD Róisín Shortall, said: ‘The cost of that has been calculated at €650million a year, and we’re saying that over the first six years that should be phased out, and that is included in our figures.’ She said removing cross-subsidisation of private care administered in public hospitals would help to offset costs.
Dr Ryan also said: ‘Based on our collective experience, the IHCA and its hospital consultant members have no confidence that the loss in private health insurance income will be replaced by the Exchequer.
‘This is especially a concern as the State has for decades struggled to adequately fund the public acute hospital system. In the context of the ESRI-projected 37% increase in demand for hospital care by 2030, removing the private revenue stream defies logic and will cripple the public hospital system.’
And he said the under-resourcing of public hospitals ‘would only serve to exacerbate the existing consultant recruitment and retention crisis.
He said: This proposal will cause an exodus of experienced consultants from the public hospitals, thereby reducing the availability of highly specialised clinical services to patients in public hospitals. The difficulties and challenges faced by the public acute hospital system are not caused by the patients in public hospitals. They are a consequence of years of underfunding and under resourcing, which have severely restricted and reduced the capacity of public hospitals to meet growing demand.’
Ms Shortall said: ‘Consultants are very exercised about the Sláintecare plan and that’s not surprising really.
‘The arrangements that they are at, at the moment, where at least 20% of our public hospital beds have to be reserved for private patients is something that’s unheard of in any other country.
‘The only reason that is happening is to facilitate consultants in
‘Astonishing underestimation’ Criticism is ‘not surprising’
increasing their private patients in public hospitals. Reserving beds for private patients is something that is called ‘a perverse incentive’ that means you’re incentivising people to do something they shouldn’t be doing, and the more private patients that are taken in our public hospitals, the more our public patients lose out. And that’s one of the reasons why there’s nearly 700,000 people on hospital waiting lists.’
Deputy Shortall said consultants are ‘up in arms’ at the suggestion that they will no longer be able to conduct their private work in public hospitals and suggested this is the IHCA’s reason for criticising the plan.