The HSE is facing more than a €1 billion shortfall in it’s finances this year. Are we surprised? I don’t think so. The HSE is a faceless organisation wasting millions of taxpayer’s money every year to fund it’s quagmire of management levels and all at the expense of frontline healthcare. In a bid to address the budget deficit, the HSE is devising a major cost cutting plan to downsize our health service and you can be sure that it won’t be the HSE to suffer the consequences. While waiting to see a specialist yesterday in an over-crowded out-patient clinic at a large public hospital, I came up with some alternative ideas for the HSE to consider. Instead of solely concentrating on cost-cutting measures in our hospitals, I would suggest that the HSE would be well-advised to look at opportunities to complement our health service.
For starters, let’s look at the area of catering in our hospitals. The catering budget must be astronomical and yet the wastage of food is phenomenal. Over the years, I’ve had many stays in hospital and I’ve often joked that this provides a saving on the family budget as my board and lodgings when in hospital, are fully covered by my health insurance. I pay dearly for health insurance and am fully entitled to this return. All medical card holders when admitted to hospital, are entitled to free care in our public health service. Those patients who are not entitled to a medical card and who do not hold private health insurance, pay a small daily levy for in-patient care. The point I’m trying to make here is that everyone regardless of income, has to budget for their daily nutritional expenses so why should the State or an insurance company be expected to pick up the tab for our food requirements when we’re in hospital? I guarantee you that if patients were charged for their meals, the wastage of food in hospitals would be radically reduced. Granted a lot of hospital food is inedible but again if patients were subsidising the cost, the standards would automatically improve.
Another aspect of hospital care which should be addressed, is the way out-patient clinics are managed in our public hospitals. There is no charge for appointments or investigations once a patient is in the public system and like all free services, it is open to abuse. By comparison, those who hold health insurance, must pay-as-they-go to be investigated within the private system, the difference being of course that they enjoy the benefit of shorter waiting times. While private health insurance is fairly comprehensive for in-patient expenses, out-patient expenses are generally poorly reimbursed. I would like to propose that all patients should be expected to pay something towards the cost of their appointments. I believe that a small charge for an out-patient appointment in a public hospital, is not unreasonable. It would not only help to offset budget deficits but would also reduce the number of appointments as public patients would take ownership of their healthcare just like privately insured patients are forced to do. This in turn would free-up non-consultant hospital doctors (NCHD) and reduce overtime expenses for the HSE.
I know I’ll be unpopular for these suggestions but I don’t care as I see it as the right way forward. At a time when the government is asking everyone to shoulder the economic difficulties, we can start by taking responsibility for our own health service. Every single person in this country should have equal, speedy, and efficient access to safe healthcare. At the moment, we have a 2-tier, apartheid health system where those that can afford health insurance, have the fastest access to health care. Let’s use patient power to save our public health service and stop the degradation planned by the HSE.
And before anyone asks why as a privately insured patient, I was seen yesterday in a public out-patient clinic, let me explain. I had no choice in the matter as I required endoscopic investigation and this service is no longer available in private consulting rooms as a result of the boom in MRSA litigation. MRSA has little to recommend it but in this regard, it has worked in my favour. I got to enjoy an appointment with my own choice of consultant, in perfectly adequate facilities and at the expense of the State. Point taken?