Money Talks

I listened with interest yesterday to an interview on Newstalk radio about in-patient services for acute psychiatric patients. This interest soon turned to outrage when I heard about the latest insult inflicted on psychiatric care in this country.

St. Ita’s Hospital in Portrane, Co Dublin was built in 1902 to cater for long-stay patients with intellectual disability. It is also the centre for acute psychiatric in-patient care in Dublin north. These facilities have been massively ignored by successive governments over the years and allowed to deteriorate to the point of neglect. It is no coincidence that the complex is on prime development land. Negotiations were started with the Dept of Health as long as 20 years ago, to agree a plan to move the acute psychiatric unit to a new purpose built facility in the grounds of Beaumont Hospital in Dublin. Dr. Richard Blennerhassett, clinical director at St. Ita’s has personally been fighting this battle to improve services since he took up his post in 1998. Agreement was finally reached, the plans were drawn-up and planning permission was obtained for this unit to proceed. It has recently emerged that the plot of land allocated for psychiatric services at Beaumont Hospital has been re-allocated to the building of a new co-located private hospital on the site. St. Ita’s now has to return to the drawing board to start the process all over again.

Frankly, I think this matter stinks. Yet again some of the most vulnerable members of our society are being disadvantaged in favour of private (for profit) health care. Our Minister for Health is insistent on driving forward a 2-tier health system in this country while the public health service continues to crumble. The concept of building co-located hospitals on the grounds of public ones is a recent one. The plans to move services out of St. Ita’s have been on the agenda at the Dept of Health for over 20 years. I’ll let you draw your own conclusions.

12 Responses to Money Talks

  1. Bendygirl says:

    It’s always the most vulnerable who’s needs are met last. I had no idea health care in Ireland was such a problem til I started reading your blog, keep up the good work Steph! BG x

  2. Caoimhin says:

    It is more than likely Steph that the government wants to get out of the Health Care business just like they did the transportation and communications industry. Pretty soon they will have nothing to do and nothing to be blamed for. Private hospitals may be our only chance, the current system is pitiful and beyond repair.

  3. Steph says:

    Thanks BG – I’m doing my best. There’s certainly no shortage of material!

    Caoimhin – Thanks. I think you have a point there. It’s so blindingly obvious that the way forward is a single tier health service with universal health insurance. This way money would be ploughed back into the one system to keep it alive and well. But no such luck, our Government seems determined to continue to run the public health service into the ground 😦

  4. Grannymar says:

    Being ill or getting old in Ireland is scarey!

  5. Baino says:

    Steph we have both a two tier system here and the practise of building private hospitals on public grounds. Royal North Shore Hospital (public and the biggest in Sydney) is currently undergoing serious investigation for a number of incidents including poor diagnosis and neglect resulting in death, whilst it’s sister hospital North Shore Private is a spit away and is run like a five star hotel. I know, my father had his knee replacement there. Having said that, we pay a FORTUNE for private health care. My recent hospitalisation of 3 days (admittedly major surgery) was $5,500, covered by health care that I pay through the nose for. Had I waited in the public system, I would have waited for 3 years for a hysterectomy. We get a 30% rebate for private health to encourage us to go into it. Again, the policy of Government is overtly to insist that they are spending on public health care but covertly encouraging all Australians to enter into the private system so that they can abrogate responsibility. We, like Ireland are becoming so much like America in terms of lack of adequate public health that it frightens me. There is no consideration for the poor, the marginalised or those requiring ‘elective’ surgery in the public system.

  6. Steph says:

    Good on you, Baino. On the ball as always!

    Your health care system sounds horribly like ours though I suspect if you saw the state of some of our public hospitals, you’d think better of your own set-up.

    I, too pay through the nose for private health insurance which is allowable against tax here also. I’d rather go without other things in lieu of paying for the insurance as I consider my health more important than anything else but that doesn’t mean I necessarily agree with the system. I don’t feel as if I have a choice. Private health insurance really only comes into it’s own for in-patient treatment. I have huge bills to pay for out-patient services and drugs. And because my medical history is complicated, I usually end up having surgery in the public hospital system anyway as many of the private hospitals don’t have the necessary expertise or back-up. However, I do get to choose my own surgeon, and his expenses and all hospital expenses are fully covered by insurance. For the same reason, private hospitals don’t operate accident and emergency services so people needing admission to hospital must be processed through the public A&E system, which is in complete disarray. The health service operates in a permanent state of crisis and every year more scandals emerge.

    Waiting lists are another scandal in Ireland. The Government has had to introduce a national treatment purchase fund to save face but of course all this does is spend tax payers money on buying in services from the private sector, thereby duplicating doctors fees in the process I think that everyone should be entitled to equity of care and waiting lists should be based on need not the ability to pay.

    The health sector has suffered huge neglect by successive Governments and ultimately, it’s the patients who suffer the most. It’s like I said, sadly, money talks!

  7. I am marginally “relieved” that ours is not the only healthcare service in the world that is going to pot… I’m beginning to wonder if crumbling healthcare isn’t part of some far greater Machiavellian plot to get “rid” of the poor and the sick. That view was strongly mooted here when the government took the view it did and refused to role out anti retrovirals to AIDS and HIV sufferers so condemning thousands to death and resulting in an AIDS pandemic with thousands of children left orphaned and also condemned to die.

  8. Steph says:

    Hello again AV

    I think in many ways medicine has become it;s own worst enemy. Medical science has advanced so rapidly, it’s impossible for any system to keep up with the huge costs involved. The more breakthroughs that are discovered, the more our expectations rise and the more costs soar. This gave birth to a private sector highly sponsored by insurance pay-outs and topped up by government hand-outs whenever a release valve is required to bale out the crumbling public sector. It’s a never ending vicious circle and makes you wonder where it will all end.

    Sometimes, I just want to stop the world and get off!

  9. nonny says:

    That is terrible, clearly those people are ignored as they are less able to fight their own corner. Obviously Harney is aiming for complete privatisation of the entire health care system. I really believe it is their hidden agenda. Eventually public patients will have no choice but to avail of private insurance.

  10. Steph says:

    I think you’re right there, Nonny

    I suspect the aim of the Government is to privatise health care and pass the buck, as Caoimhin has alluded to above. The tactic is to deplete the public health system to such a level that the majority (those who can afford it) will be forced to seek private health care. The co-location issue is a clear example of how the present Government is backing privatisation instead of sorting out the chaos in the public hospitals.

  11. Maeve says:

    Privatisation will not solve the health problem even if everyone could afford to buy private insurance, which of course cannot happen given the level of average wages in Ireland. If the whole cost of hospitalisation, outpatient visits and the attendant laboratory tests are to be borne privately then Irish people will not, with the exception of a very few be able to afford it. In order for private medicine to work then the public system must fail and that is the plan of the present government. The myth that private medicine is more efficient and less costly than public medicine is a myth. An OECD report on expenditure on health in twenty-nine countries found that those that had a public health system spent less than those that had not. Less is also spent on administrative costs, as an example Canada spent only 1.3 per cent in 2003 while USA spent 25 per cent on administrative costs. And we know how people are treated in the US if thy do not have insurance! The solution is a single tier system with a national insurance plan for all so that everyone is treated equally. People have private health insurance out of fear and we should all fight for a proper public health system for all, and there would be no need for this tax by the back door.

  12. Steph says:

    Welcome! Maeve

    I’m with you 100% on what you say here. I’m all for a single tier not-for-profit system of healthcare.

    Thank you for this useful contribution to the debate and please do join in again sometime.

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