#RealityCheck: What happened to the Five Point Plan in relation to Health?

The Sunday Business Post's Susan Mitchell speaks to Newstalk Breakfast about the Government's health plan

You may remember that famous Fine Gael five point plan which was going to rescue the country.

The Plan:

Our Health system doesn’t work. Fine Gael’s strategy will eliminate long waiting lists, end the unfair public-private two-tier system and replace it with a universal health insurance based on the renowned Dutch model. A greater emphasis on diagnosis and treatment in the community will ensure shorter hospital stays.

What the programme promised:

  • A system based on need not income
  • Universal Health Insurance introduced
  • Special Delivery Unit to reduce waiting lists
  • A patient safety authority, incorporating HIQA, will be established
  • Free GP care for all
  • Encourage GPs to defer retirement and will recruit from abroad
  • Public hospitals will no longer by managed by the HSE, they will be independent trusts
  • Smaller hospitals will combine into local networks
  • The Health Insurance Fund will ensure hospitals in remote locations can continue to provide important services
  • For the elderly, there will be more residential places, more home care packages and more professional community care services
  • Reference pricing and greater use of generics will be introduced
  • Consultant’s pay will be reduced
  • The HSE will cease to exist
  • Health capital spending will be a priority
  • We will reduce stigma of mental illness, ensure early and appropriate intervention and vastly improve access to modern services
  • National Dementia Strategy
  • Cervical Cancer Vaccination Catch-Up Programme

What's the reality?

This morning, Newstalk Breakfast cast a critical eye back over the performance of the Government in the context of the promises made in the five-point plan.

Susan Mitchell, the health correspondent with the Sunday Business Post, ran through whether the Government have come through on any of their plans.

How have the Government parties performed?

Susan commented: "I think you can only describe their performance to date as pretty poor because the majority of their commitments and promises in the programme for Government and indeed before the last Election, revolved around eradicating the so-called two-tier waiting lists for access to hospital care. This is, if you have private health insurance, you get in, you get your procedure or your appointment very quickly... but if you were in the public system, you languish on waiting lists.

"They intended to do this by introducing Universal Health Insurance. That's obviously abandoned.

"There is some progress on free GP care because they have rolled that out to under-6s and over-70s but in the main, access has disimproved."

Universal Health Insurance 

On this, Susan stated: "It wasn't costed before an announcement was made. They even trotted the Taoiseach out at one point to launch the white paper on it etc. but they didn't cost and they really only costed it last year when the ESRI came out with a report saying that it would be far too costly for us to introduce it. At that point they said, ok we're not going to introduce Universal Health Insurance but we are still determined to introduce Universal Health Care."

Primary Care

"They promised free GP care to all of us. The Government was supposed to deliver that during its term in office.

"Initially what was promised was that they would roll this out to people with long-term illness cards.

"Then they realised that was undoable. Apparently there was some kind of legislative difficulty there so they then decided to proceed on the basis of age.

"There's been a lot of criticism from GP groups in particular about the decision to give free GP care to under-6s. This, generally speaking, is a relatively wealthy cohort of the population."

Medical Cards

"There has been a significant improvement in that area. There was a huge cull of discretionary medical cards. 

"The Government said you need to start saving money on the medical card scheme, so the HSE began to review this. Then obviously there was absolute outrage on the doorsteps, the Government took a hammering in the local elections and there was a decision, ok we need to change our policy on this.

"The overall number of medical cards has increased substantially under this Government."

HSE

In terms of abolishing the HSE, Susan commented: "It hasn't happened. There's still no clarification or no clarity around when that's going to happen.

"The original plan as outlined by Minister Reilly was that you would have smaller hospitals doing more elective procedures and then you would have the bigger hospitals... concentrating on more difficult aspects of acute care."

Do we have a more efficient health service today?

“We probably do have a slightly more efficient health service than a couple of years ago.

“There is a little bit of a myth of the number of managers and administrators in the Health Service... the figures in the NSH are very, very comparable”

Waiting Lists

“The Government has changed the target on waiting lists.

“The target for an outpatient appointment was brought down to one year by James Reilly, then that was changed ... Varadkar set a target of 18 months. That’s now reduced to 15 months.”

“Under the previous Government there were 9,000 patients waiting six months (for an outpatient appointment), we now have 25,000 patients waiting six months for their car.

“In fairness to the Government there has been some progress in terms of the long waiters, but there is a huge bulge in the middle.”

Trolley Crisis

“That has really been something that has come back to bite the Government in a big way. We all remember the promise that Enda Kenny made in advance the election before last where he said they would end the scandal of people waiting on trolleys. Well they certainly haven’t, as we hear from countless media reports week in, week out.

“If you look internationally this is not the norm internationally. There are headlines screaming in the UK about waiting times in the NHS – they’re worse than they ever were etc. But worse than they ever were there still means that only one patient in every ten waits longer than four hours to be discharged or admitted to the hospital. Here 30% of patients are waiting longer than six hours.

“In the main this relates to a shortage of beds. Ireland has one of the lowest number of beds per capita in the OECD – there were a large number of beds taken out of the system. The problem in emergency departments is not the numbers of presenting, it’s the numbers boarding.

“Then there’s a host of other things, like the admission rates vary hugely from hospital to hospital, nobody can quite explain that.”

Final Grade

"(The Government) probably over-promised to be fair to them, but they certainly didn't live up to expectations."

 On Wednesday morning on Breakfast we look at the Government's commitment to jobs

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