Tuesday, June 12, 2012

Can Europe help us fix our public health service?


Long waiting lists for elective surgery, overworked A & E departments and in-patients having to be accommodated for long periods on hospital trolleys are the kind of stories we keep hearing about in relation to the Irish public health service. Of course these things are unacceptable. But bad as they are, a letter to the editor of the Irish Times on May 27th 2012, from a GP, has described a situation that should be made a criminal offence when and if a culprit can be identified.

The letter indicates a level of inequality that simply should not exist in any country, developed or otherwise. It illustrates that ability to pay and not need is the criterion for hospital treatment here in Ireland. Read it here.

There are also the inadequate care services in Ireland for those who suffer from Cystic Fibrosis, despite the fact that we are among the countries with the highest incidence of this condition. These have been well documented on many occasions by Orla Tinsley.

The letter above prompted me to do some research. I was able to locate a report on European health services that seems detailed and is up-to-date. It’s from a Swedish benchmarking group called the Health Consumer Powerhouse, it’s called “Euro Health Consumer Index 2012”, it’s by Arne Bj√∂rnberg, Ph.D., and it can be accessed here in .PDF format.

While inequality of the type highlighted in the letter to the Irish Times as it relates to Ireland is not dealt with specifically in the report, it does examine the issues of waiting lists and the cost of health care on a per capita basis in a total of 34 countries, the majority of them within the EU. In relation to Ireland, two graphs stand out. The one for waiting list times shows Ireland six places away from being the worst out of the total of 34. At the best end of the list lie Switzerland, Belgium, Germany, The Netherlands, Denmark, France, Austria, Finland and Sweden, with the lowest waiting times. But here’s the thing: In the graph that shows healthcare spend per capita, Ireland is right up there near the top along with Denmark, Germany, Belgium, Austria, The Netherlands, Switzerland, Norway and Luxemburg.

The author of the report has the following to say about waiting times:

2.3 Major non-acute operations < 90 days

What is the interval between diagnosis and treatment for a basket of coronary bypass / PTCA and hip/knee joint? It is difficult to avoid the observation that for countries, which do have official waiting time statistics (Ireland, Sweden, UK etc), this is in itself a not very flattering circumstance. Countries such as Germany, where waiting times tend to vary in the 2 – 3 weeks range, have never felt the urge to produce waiting time data, for principally the same type of reason that Madrid has less snow-ploughs than Helsinki”.

A fair comment, but one is still left with the belief that pure inequality, as opposed to typical waiting times, is unique to Ireland, at least within the EU. This is supported by anecdotal evidence from people who have experienced public healthcare in France, Belgium, The Netherlands and Germany.

Once again one is prompted to ask why there is such an antipathy to the EU on the part of the radical left wing here in Ireland. If they were real Socialists they would, surely, embrace Europe as an exemplar of equality and anti-discrimination, and not as something to be viewed with suspicion. If they were doing their jobs on behalf of the users of health services in Ireland they would be beating a path to Brussels to highlight the woeful inequalities that have been described here, and getting all available help to remedy the situation.