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The only certainty is uncertainty

There is a touch of anti-climax in the air following the publication of the report of the Oireachtas Committee on the Future of Healthcare. But then again, we already knew the pillars of the report, which had been strategically leaked to the national media over recent weeks, it would seem, and surely not because of a potential election in the ether.

Thus, by the time of the 9 o’clock news on RTÉ television, on the day the report was launched, it had slipped well down the news agenda.

The key tenets have been well publicised: More care in the community; extension of free GP care over a five-year period; removal of inpatient charges for public hospital care; a legislative basis for universal entitlement to healthcare, with maximum waiting times; and removing private care from public hospitals (with the major caveat of an independent impact analysis of this separation).

A pressing need for extra medical staff is acknowledged in the report. The issue of pay is also touched on, although non-specifically: “The Committee received extensive evidence from demotivated staff, many of whom are considering migration or have already migrated. As the economy recovers and prospects for renewed pay deals emerge, the issue of pay should be addressed. However, it is also essential that issues that were the cause of demotivation are understood and dealt with.”

It should be noted that there were lukewarm (and sometimes frosty) responses from medical organisations, many of which see merits within the report, but fear they will be asked to do more with less, and also lose some of their current entitlements.

The plan’s implementation would require an extra €5.8 billion ploughed into health over a period of 10 years. But the report is non-specific on how this funding will be generated, reflecting the inevitable political tensions that would have represented a constant ‘white noise’ to deliberations.

The report states that funding would flow into a National Health Fund, including a mixture of general taxation and specific earmarked funds, “to be decided by the Government of the day”.

The Committee has recommended the setting-up of an Implementation Office under the auspices of An Taoiseach by July 2017, with a remit to oversee and enable the implementation of this plan and develop a detailed implementation plan for the reform programme.

The positives are that some consensus points have been agreed across parties and are translated into black and white, even if the ‘ink’ is smudged into a conspicuous shade of grey at times.

Meantime, the Fine Gael leadership race was accelerating at press time, with Leo Varadkar still in pole position. If he does become Taoiseach, perhaps this important report will test the strength of his promise that he has ‘unfinished business’ in health, a portfolio he reputedly wished to be moved from in the last Cabinet reshuffle.

Whoever lands the ‘gig’ needs to make sure this report is one that doesn’t gather dust: The pressures of population demographics, multimorbidities and failing recruitment and retention are simply too pressing.

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