‘Scale of our waiting lists remains extraordinary’, Oireachtas health committee told
The health system continues to be “a cause for scandal”, with the “spectacle of vulnerable and sick people waiting on hospital trolleys and plastic chairs sadly [still] commonplace”, an Oireachtas committee has been told. The Health Committee also heard many of the Sláintecare reforms have “faltered”, with the problems in health “inextricable from a political context in which healthcare in this country is not regarded as a basic right of all people”. There were calls for legislation to make universal healthcare an entitlement rather than a policy aim. Dr Domhnall McGlacken-Byrne, one of the co-founders of Doctors for Universal Healthcare, appeared before the committee. He said a system that gives everyone access to care when they need it, no matter who they are, was “premised on a conception of healthcare not as an economic good or an item of charity, but a human right of all people”. He said Ireland did not have such a system, either in policy or in practice. “In our hospitals, the scale of our waiting lists remains extraordinary,” said McGlacken-Byrne. “Earlier this year, the number of people awaiting specialist hospital care surpassed one million, a remarkable figure for a country of our size. In our emergency departments, the spectacle of vulnerable and sick people waiting on hospital trolleys and plastic chairs sadly remains commonplace. Our public and private hospital systems continue to overlap in a way that is complicated, inefficient and unfair.” He noted that “half of Irish people feel the need to buy private health insurance ”, adding: “In return, we get systems of care which too often are overburdened, fragmented and difficult to access. This is a bad deal.” Sláintecare was adopted in 2017 to reform the system and implement a policy roadmap to universal healthcare. He said it has had “some successes, such as the introduction of the chronic disease management programme in general practice, and the public-only consultant contract in our hospitals”. He added, however: ”Many of the Sláintecare reforms have faltered.” McGlacken-Byrne pointed to the lack of access to GP care to cover the whole population and “stubbornly high waiting list figures and trolley statistics”. He called for “sustained, targeted, equitable investment in primary care, in acute services and in prevention”, and said hospitals “urgently require expansion of public hospital capacity”, with universal primary care rolled out swiftly. Associate professor Sara Burke, director of the Centre for Health Policy and Management at Trinity College Dublin , said a broad commitment to deliver universal healthcare was welcome, but conceded that “despite the policy intent, Ireland is a long way off having a universal health system”. She said there is “considerable ambiguity about what ‘universal’ actually means in practice and this perhaps has caused the public to disengage with the issue, denying us an important force for change”. Burke said progress “requires moving beyond eligibility expansion towards a clearer statutory entitlement framework, supported by sufficient workforce and service capacity, public understanding, engagement and support. Universal healthcare will only be realised when quality care is consistently available and accessible in practice, not merely promised in policy.” The chairman of the committee, Social Democrats TD Padraig Rice, called for a return to the principles of Sláintecare and an “acceptance that reform costs money and that investment will pay dividends later”. He said there were “enough factors already working against Sláintecare including the strength of private sector lobbying”, adding that the committee had an obligation to “reaffirm our commitment to Sláintecare and redouble our efforts to ensure it’s fully implemented”.