Public campaign needed for national health service in Ireland

In the South we often look enviously at the British NHS.

From the injustice and inequality of our two tier system, from our GP waiting rooms where we will have paid €50 or €60 to see a doctor, we see how the NHS was at the center of the debate in the British General election campaign.

As efforts to push citizens in the South into the private health market are ratcheted up we see the growth of grassroots campaigns in support of the NHS. We have heard the emotive words of campaigners such as Harry Leslie Smith who called on the British people to stand up and defend the NHS.

Yes, we recognise that the NHS has its own problems. Under the Tories it has suffered from cut backs and attempts to pursue a privatisation agenda. And with the election of a majority Conservative government the future for the NHS is far from secure.

But for now the debate is quantitatively different.

NHS campaigners are fighting to keep what they already have – to retain something which many British people feel great pride in.

Here those of us who want to see a universal health system are fighting for something we have never had.

And the odds are stacked against us.

Against us stand the vested interests. The private health profiteers. The proponents of neoliberalism. The EU rules on spending and borrowing brought in by way of the Fiscal (Austerity) Treaty.

But there is too much at stake to let that stop us.

We all know people who have been let down and failed by the two tier health system.

We know people who cannot afford health insurance but have borrowed money to have a cancer test privately because the time they are expected to wait in the public system could put their lives at risk.

And we know people who can neither afford insurance nor to borrow for healthcare but who have to wait. Sometimes in pain. Sometimes in fear.

We have seen public patients with late diagnosis die where private patients survive.

An example of this was the high profile case of health campaigner Susie Long.

Her story of her seven month wait for a colonoscopy in the public health system in 2005.

Her late diagnosis.

Her encounter while undergoing chemotherapy with a private patient who had been referred for a colonoscopy at the same time as her but got it after 3 days.

His survival.

Her death.

There have been many other cases just like this.

So many ordinary people whose stories will never be told.

This is an inequality and injustice which many of us are simply not prepared to accept.

So how is it then that we do not have a more vocal public campaign for a national health service in Ireland?

It is back to how this debate is framed and how the dominant political ideology over recent years has seen a greater focus on putting money back in people’s pockets than on strengthening public services.

But for most people on low and middle incomes the pennies they put back in your pocket won’t buy you the healthcare you need.   Remember Susie Long’s case occurred in the boom years of the Celtic Tiger.

We need to start discussing how we build a public health system and how we pay for it. And why a progressive tax system that asks those who have more to pay more is the fairest way to do this.

People’s greatest fears around paying more taxes are what that money will be used for. Sometimes the record has not been good – waste and excessive pay have undermined public confidence. But for many they are open to paying more tax if they are genuinely getting a better service for it.

A public health system would mean many people would not have to pay the exorbitant private health insurance costs which they feel they have to pay for at present.

Healthcare and the choice between public and private is a debate that goes to the heart of what kind of society we want to live in.

It is a debate between those who clearly see that the state must stand by the responsibilities which it has progressively adopted over the last two centuries and those who want to minimise the role of the state – a battle between those of us who believe the in the essential value of solidarity between citizens and those who don’t.

For many the United States stands as a forewarning on what you get when you go down the private health route. Gross inequality. Crippling healthcare costs. Healthcare costs pushing up the costs of living.

But it is worth looking to developing countries to understand how bad it can get when governments cut back on healthcare spending at the behest of those pursuing a neoliberal agenda.

In developing states we have seen how the absence of a developed public health service has impeded the ability to control epidemics such as Ebola with consequences for both citizens in those countries and globally.

The question of the IMF’s role in the Ebola outbreak in Sierra Leone is illustrative of the moral bankruptcy of that organization and neoliberalism as a whole. It is illustrative of its incompatibility with social justice. Structural adjustment programmes created the conditions that made it inevitable that the health system of Sierra Leone would not be able to cope with an outbreak of a contagious disease. Sierra Leone along with Liberia and Guinea were engaged in IMF structural adjustment programmes at the time of the Ebola outbreak – the constraints on public spending meant quiet incredibly that Liberia had only 60 doctors before the Ebola outbreak while Sierra Leone had only 136 with populations of four million and six million respectively. For more on this it is worth reading the Lancet Medical Journal’s article of February 2015 entitled “The International Monetary Fund and the Ebola Outbreak”.

While the experience of the countries affected by Ebola is extreme it is ultimately where the neoliberal and anti-public services agenda brings us.

Neoliberalism may seek to make us individually responsible for our well-being but it cannot change the essence of our interdependence.

In working for a universal health system the challenge now is to promote solidarity as a core value, essential to building a fairer society.

We need to counter individualism and consumerism and false freedoms (such as putting the money in your pocket to pay for your own healthcare) that have done so much to destroy societies, communities, lives and the environment.

It is time to recognise that public healthcare provision is a cornerstone of what a progressive state does for its citizens.

As Britain stands on the verge of discarding the great legacy of Aneurin Bevan and the post war Labour Government, in Ireland it is time to build an alliance of ordinary people, patients, healthcare professionals and political representatives to work towards building a universal public health system for all of Ireland.




  • Korhomme

    During one of their financial interventions, I think it was in Indonesia, the IMF declared that health care provision was a ‘luxury’. That single phrase speaks volumes.

  • chrisjones2

    “Under the Tories it has suffered from cut backs ”

    No it didnt. We are spending more than ever. Thats just Labour propaganda regurgitated without thought

    “attempts to pursue a privatisation agenda”

    started by the last Labour Government and a good idea in some areas eg you can now get free glasses and hearing aids on the NHS far faster via local contracts with Specsavers, Boots etc alongside private punters who are paying hundreds for the same service. In NI we don’t have that and our punters wait months for NHS staff to get around to seeing them. Why do you object to better services for NHS users?

    “And with the election of a majority Conservative government the future for the NHS is far from secure”

    Again just socialist waffle and scare mongering.

    “emotive words of campaigners such as Harry Leslie Smith who called on the British people to stand up and defend the NHS.”

    Who? Never heard of him. And again this is all just pre election waffle. Dont forget that the greatest scandals of the HNS killing patients took place under the good old socialist Labour NHS.

    “Against us stand the vested interests. The private health profiteers. ”

    Always handy to have a bogey man innit

    “The EU rules on spending and borrowing brought in by way of the Fiscal (Austerity) Treaty.”

    A bit vague that one but if you mean the state is broke then thats fine but the money has to come from somewhere so what do you want cut to pay for it? Childcare? Care for the elderly? Policing and justice? You might ask SF the same as in NI they have been pretending that they have a Magic Money Tree.Sadly it finally wilted on Friday

    You then blame the IMF for the outbreak of Elboa in West Africa. You do seem very confused though. Do you suggest that Ireland and other IMF members must fund full western standard healthcare programmes everywhere in the world to fight every disease? A laudable aim perhaps but one that will bankrupt everyone and how will it stop a disease like Elboa for which there is no cure and whose vectors depend often on ignorance and local social practices and are compounded by local government inefficiency and corruption which the IMF is trying to fight. Your argument is like blaming doctors trying to treat cancer for the fact that sometimes it is detected too late or the treatment doesn’t work.

    It doesn’t seem to have sunk into your consciousness that if you do that you will be unable to fund healthcare at home too

    “We need to counter individualism” Wonderful idea but Hitler Stalin Mao and Pol Pot all tried it.It didn’t work and has bad (often terminal) side effects. People also tend to call it fascism

    I think your GP might prescribe a lie down in a dark room for a while.I also recommend you carry our more research on various political systems that may help

    You have two cows. The government takes one and gives it to your neighbour.

    You have two cows. You give them to the government, and the government then gives you some milk. If you complain the Government sends you for re-education.You are never seen again

    You have two cows. You give them to the government, and the government then sells you some milk. If you complain the Government shoots you

    European Capitalism:
    You have two cows. You sell one and buy a bull

    American Capitalism
    You have 200 cows all of which are undocumented aliens

    Irish Capitalism
    You buy 200 cows with a loan.Give them away to family members then declare bankruptcy and blame the bank for being stupid enough to lend you the money
    You have two cows. The government takes both and shoots you.

  • Old Mortality

    Universal health systems face two major problems. First, the absence of any incentive for the beneficiaries to preserve their health; second, the reluctance of the providers to fully embrace the public service ethic. It would be folly for the RoI to embark on such a project unless it can find the answers to these problems.

  • chrisjones2

    Sadly for some it is.They will drink themselves to near oblivion and wash up in A&E, take drugs,recklessly get pregnant and contract STIs assuming the state will sort them out

  • chrisjones2

    We need an NHS

    I can confidently say it has saved my life at least twice and when my father was in his 20s it saved his life and he went onto live to his mid 80s.

    But I want to see one that is efficient and effective and a good – indeed joyous – place to work.Not the present system riven with little empires, careerism and disputes

  • barnshee

    try France and Germany

  • “As Britain stands on the verge of discarding the great legacy of Aneurin Bevan and the post war Labour Government…”

    No, it doesn’t.

    “…it is time to build an alliance of ordinary people, patients, healthcare professionals and political representatives to work towards building a universal public health system for all of Ireland.”

    Yeah, good luck with that. Let us know how you get on…

    “The proponents of neoliberalism.”
    Sorry, I dozed off there…

    “In the South we often look enviously at the British NHS.”

    Well, you should start a campaign to re-join the UK then! Obviously!

    The rest is agit-prop.

  • JohnTheOptimist

    There is no evidence whatever that state monopolies are better than the free market at providing good healthcare. It is generally accepted nowadays, in relation to the provision of most services, that state monopolies are bad. Why should healthcare be any different?

    The NHS has made the UK one of the unhealthiest countries in western Europe, with Scotland and N. Ireland (to a lesser extent than Scotland) having the worst health statistics in the UK. The idea that the NHS is one of the best healthcare-providers in the world is one of those myths that are frequently repeated, but never supported by any objective data.

    There is a growing list of healthcare scandals in the UK, the South Staffordshire hospital debacle being only one.

    According to Eurostat, a person born in the ROI can expect 68.5 healthy years during their lifetime, while a person born in the UK can expect only 64.5 (link below).

    Overall life expectancy is 2 years higher in ROI than in Scotland and 1 year higher than in N. Ireland. The UK has the highest infant mortality rate in western Europe (much higher than the ROI), and N. Ireland has the highest infant mortality rate in the UK. In terms of all-age mortality rates, Scotland is by far the worst performer in western Europe, and N. Ireland the next worst. Mortality rates for under-60 age-groups are around 20% lower in the ROI than in N. Ireland and around 30% lower than in Scotland. Health surveys such as Slan (and its counterpart in N. Ireland) show the proportion of people rating their health as ‘excellent’ or ‘very good’ is much higher in ROI than in N. Ireland across all age-groups.

    The last thing the ROI needs in a NHS. Hopefully the Tories will move healthcare in the UK in the direction of allowing much more private insurance, along the lines that currently exists in the ROI. There is a school of thought that believes that when people make a modest financial contribution towards their own healthcare-provision, they are more likely to look after their health better. The evidence seems to bear this out.

  • Brian O’Neill

    There is lots of evidence that the NHS is the best in the world:

    “The United Kingdom ranks first overall, scoring highest on quality, access and efficiency,” the fund’s researchers conclude in their 30-page report. Their findings amount to a huge endorsement of the health service, especially as it spends the second-lowest amount on healthcare among the 11 – just £2,008 per head, less than half the £5,017 in the US. Only New Zealand, with £1,876, spent less.

    In the Commonwealth Fund study the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at. It got top place on measures including providing effective care, safe care, co-ordinated care and patient-centred care. The fund also rated the NHS as the best for giving access to care and for efficient use of resources.”

    So privatisation is not only unfair, unsafe but it also costs more.

  • chrisjones2

    Depends what you privatise and how you do it.

    Emergency medicine – no – spectacles, hearing aides and many more issues – yes

  • chrisjones2

    I am unaware of any reliable figures. If you want proof wander into the A&E at the RVH or Ulster on a Friday Saturday or Sunday night and you will see them

  • chrisjones2

    Yes but the NHS is one of the worst examples I have ever seen and the issue is when empires compete or cover up to protect the clan

  • JohnTheOptimist

    So, how come the UK fares so poorly for infant mortality?

    Ditto for maternal mortality and a host of other mortalities.

    Life expectancy in Scotland and N. Ireland are the lowest in western Europe and lower than in the Republic of Ireland.

    Socialist system always get a good press from leftwing commentators, academics and researchers. That’s what they are paid to do.

  • GEF

    Can anyone in their right minds believe SF voters would enjoy paying €50 or €60 to see a doctor in a new 32 county Ireland

  • chrisjones2

    Sorry …you are right on spectacles. Its been privatized very successfully for years which sort of proves my point. Hearing aids is more recent and only in parts of E&W but it too illustrates the point

    As for the paperwork – that’s just NHS protectionism., A symptom of the problem. Devolve budgets to GPs with a simple basic audit

    But we wont do that in NI – too many hungry civil servants all trying to do a good job but who sepnd their days managing appointments, shuffling papers, buying different hearing aids, fitting them, auditing all these things their colleagues have done, preparing multiple reports for more senior officials and minsters on hearing aid statistics for the last 20 years and planning how the system can be further optimized to save 0.1% per annum, filing the mountain of paperwork generated and answering Ministers Cases letters from public representatives whose constituents have been waiting 4 months stuck in the current system

  • Kevin Breslin

    I have no problem with Ireland trying to develop a universal healthcare model similar to how Scotland did. The reality is there was no public will for that convergence to happen. Nonetheless that would not deter me from seeking healthcare in the Republic.

  • Kevin Breslin

    How many votes do Sinn Féin get in the Republic?

  • Kevin Breslin

    Where do the next generation of taxpayers come from to pay our ageing population if people don’t get pregnant? Migrants?

  • Korhomme

    If you’ve never heard of Harry Leslie Smith, then search for him, buy and read his book, and see what things were like pre 1940 for far too many people.

  • the rich get richer

    What is the quality of the health care on the NHS. Good if you are knocked down by a bus or an accident.

    Sadly not so good if you have a longer standing condition. This has been my own personal experience and I am sorry to have to say it.

    On occasion the equivalent of a pat on the head and come back again in 3/6 months for another pat on the head.

    Some of the staff are downright lazy and carry on as if they don’t have a care in the world (certainly not whether their job is in any danger)

    I am sure their are many good people in the NHS but sadly for me there certainly are some that just not too bothered.

  • chrisjones2

    Read it? My family lived most of it in Belfast!

  • chrisjones2

    Key issue. Is the punter happy? is the problem solved? Is the cost to the sate reasonable and controlled?

    If a company makes money too – good luck to them

  • notimetoshine

    If a state health system is so bad then tell me why the bastion of private healthcare provision has a higher infant mortality rate? 6.2 I believe.

    There are demographic, cultural and lifestyle reasons that also affect mortality rates.

    Post hoc ergo propter hoc