Wednesday, March 3, 2010

Pirates of the Celtic Tiger

A true tale of modern-day piracy, featuring: one small, damp island; lots of treasure; some pirates in pretty sharp suits; and a government that does whatever they ask. Oh yes, and YOU get to walk the plank!

Lying on the Hospital Trolley, Dreaming of Prada

It is not so long ago that Ireland was awash with cash. There was so much money out there even the Department of Finance couldn’t keep track of it. Every year when they did their figures, they found – oops! – the tax take is a couple of billion more than they’d planned. Now we are in reverse and we are borrowing heavily to pay for other peoples mistakes. The Celtic tiger is a hazy memory, like an all-night party which left you with a nasty hangover, embarrassing memories and an empty pocket. The pirates of the Celtic Tiger - the bankers, their politician friends and wealthy developers have run away with the wealth and left us deep in debt.

Despite all that money, we still don’t have a proper health system. That surely is a travesty. Our health system is still in deep crisis. Part of the problem is that it is still suffering from the deep cutbacks imposed by Fianna Fail-led governments in the 1980s. There are less beds in Irish hospitals today than there were 25 years ago – despite the country’s population being significantly greater. Another issue is the lack of an adequate system of primary care and the shortage of step-down beds, which leads to patients with minor problems or who are in recovery being treated in hospital. But the key problem is that government spending on health is swelling the coffers of the private sector. This is because Ireland has a mixed public-private health service, with the private sector subsidised by public funds.

Take the example of hospital consultants. Consultants on contract to provide services to the public health system are allowed maintain a private practice at the same time. They can see their private patients in a public hospital, using public facilities, during public time. This bizarre practice naturally leads to a situation where consultants, who are paid to work in the public health service, focus most of their energies on their more lucrative private patients, leaving public patients to be treated by non-consultant hospital doctors.

Another example of how public funds are used to prop up the private sector is the National Treatment Purchase Fund. Medical treatments which the state sector cannot provide are purchased from the private sector in Ireland and abroad. So what, you might say, so long as the patients get treated? But the result is another black hole into which taxpayer’s money disappears, and a further weakening of the public sector.

A third example of the creeping privatisation of health is the plan to gift public land on the sites of existing hospitals to the developers of private clinics. In return, these are meant to provide a certain number of public beds. Of course, the government could simply extend the public hospitals…but that would miss creating a “market opportunity” for the private sector. We get to walk the plank again.

Don’t let yourself be fooled: there’s a very good reason why you can’t get a loan to buy a house, or that you are paying over the odds for the one you have, or you can’t get proper health treatment. While you’re waiting, other people are laughing all the way to the bank – or lobbying the politicians for the next bank or developer bailout. Until we elect a government that isn’t in harness to the corporate pirates, the only thing that will change are the talking heads sent on TV to explain why one of the wealthiest countries in the world cannot afford to provide its people with some of the basic decencies of life.

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