It’s not all about money. How about a bit of thought? That would be nice, especially when it comes to healthcare.
Is there anywhere else in the world that went through a traffic-light controlled roundabout fetish in the same way as we did in the 1990s? Of course we didn’t care. It was other people’s cash. It took us a few years of log jam to realise flyovers ease traffic manage. Again it was other people’s money camouflaging as capital money. We wanted shiny motorways like those who gave us the EU grants. Any motorway would do and we loved our roundabouts with traffic lights. We just didn’t think it through.
Not thinking things through has been a constant theme of Undaunted columns, particularly when it comes to providing services to disabled people. No joined up cash. We simply throw money at it and hope it goes away. We can also say ‘but we spent this huge amount on you. Why would you want more’?
We like throwing money around. Even now. It’s called our health budget.
The thing is, and forgive me for upsetting you, we are not spending THAT MUCH on health. Don’t take my word for it. Today the Organisation for Economic Co-operation and Development (OECD) issued its 2015 Health at a Glance report. It tells us Irish health spending is close to the OECD average, at 8.1% of our gross domestic product. However, it's worth noting that spending fell at a faster rate between 2009 and 2013 than in any other country - apart from Greece and Luxembourg.
We can understand why Greece cut its budget, while the size of Luxembourg isn’t really a comparison that’s useful. In percentage terms health attracts 13% of Irish government spending, far less than in the US (20%) or Germany (19%). Even that should be taken with a grain of salt.
Would you want a health system like the States? Of course not. It goes back to planning as the following example illustrates. We produce the highest number of medical graduates but also rank fourth in the number of foreign-trained doctors. So, we spend cash training them but allow them leave and then pay premium for their replacements. Clever.
The really depressing thing is that planning isn’t coming to a health system near you any time soon. Mini-empires have been built. Brass plates are used as weapons of defence. On the other hand, politicians with have a love of really big numbers will jump at the chance of throwing money without thinking.
We’ll be stuck on that roundabout forever.
