Imagine your child is sick. Imagine you have no money to
spare but you’re not going to take a risk with your child’s health. You take
your child to the doctor and your child is treated for free.
Is this the dream of an ideologically-driven Minister for
Health?
No, it was the reality of the British National Health
Service fifty years ago. I was that child.
Growing up in the 60s in the UK, the only concern for both
doctor and patient was the patient’s health. And if your child was really ill,
the doctor would come to your house by appointment. For free.
When I came to Ireland in the 90s and visited the doctor
with my own children, a cold shudder passed through my body as I fumbled for a
cheque book or scrambled for some cash.
I thought: “What if I
couldn’t afford this?” Would I have taken the risk that it was “just another
virus and antibiotics would be of no use anyway?” But then what if it wasn’t a
virus? What if it turned out to be the onset of something more serious like meningitis
and my dithering had jeopardised my child’s life?
The National Health Service in the UK was brought in by the
post-World War Two Labour Government, a government that was elected on a social
democratic tide that sought to implement the community spirit that had
flourished during the war.
Churchill’s Tories – despite his service as a War Leader –
were rejected in favour of a more egalitarian vision of society.
The post-war Government’s reforms in both health and
education created improved opportunities for all, regardless of income, on the
basis that these issues were fundamental rights in a mature democratic society.
To this day, the much maligned and undermined NHS - which
experiences the same kind of challenges as the HSE - remains sacrosanct as a
concept for the British electorate.
And despite the justified criticisms about its waste and
inefficiency, it is telling that only 12 per cent of Britons choose private
health care.
In the UK, there is no begrudgery that the rich have the
same free access to health care as the less well-off, yet these arguments are
put forward almost on a daily basis by critics of Leo Varadkar’s proposals for
free GP care for children under six.
That’s because there’s an acceptance that if the rich are to
pay more in taxes to subsidise UK Government services, it will be done by simpler
tax models, rather than mean-spirited means tests that are hugely costly to
administer.
The other bizarre argument against Varadkar’s initiative is
that it will in some way penalise children over six who have serious conditions
- and indeed all others with acute GP needs.
This narrow approach sees Government expenditure as
compartmentalised and fixed. The available expenditure at the disposal of
Governments rises and falls with every economic fluctuation and ministers have to
make the case for the financial requirements of their departmental budgets. Do
critics really imagine that if the Government’s proposals were not implemented
that other areas of acute need would be better served?
Furthermore, it is important to remember that this is the
first step in the Government’s policy to provide free GP access for all. The
current proposals should be seen in that context.
Health is the most fundamental issue facing us all. It is
about time it was put front and centre of public policy.
That is not to say that it should become a black hole into
which resources are poured without proper supervision but it is to say that
there are much bigger management issues that the Government should be held
accountable for.
What if the chaos of Irish Water and its convoluted
initiatives and reverses had been avoided? How much of that expenditure would
have been better served had it been diverted to meet some of the financial
challenges presented by our health care services?
It’s clear that there are a huge range of inadequacies and
inequalities that need to be addressed in our health care system and arguments
will rage over what the priorities should be and how much should be spent on
them.
But is this hopeless and helpless hand-wringing about the
monumental task ahead an excuse to make no progress at all towards a fairer
system?
Bob Hughes is a journalist, writer and media consultant.
He was formerly Deputy Director of News at TV3 and a
producer at Channel 4 News, Sky and Reuters.
Twitter: @bobhughesnews
