PRESS RELEASE, Monday, October 21st, 2013
- Government must explain why it is ignoring revenue raising public health measures.
The Irish Nurses and Midwives Organisation (INMO), following a detailed analysis of the Budget, which requires a further €666 million to be withdrawn from the Health Service, has concluded that:
- Patient care will be severely compromised as the public health service faces its sixth consecutive year of cutbacks; and
- The government, while imposing these cuts, has refused to introduce targeted, revenue raising, public health measures in areas such as smoking, alcohol and sugar sweetened drinks (S.S.D’s).
The INMO believes the inevitable outcome of these two contradictory strategies will be a wholly inadequate, and underfunded, health service unable to cope with the demands of a population while the government refuses to raise revenue from proactive public health initiatives.
The Government’s approach is totally ill-advised for the following reasons:
1) Health Service Capacity
The current state of our health service can be summarised as follows:
- Over the past 5 years the budget has been reduced by €3.3 billion or 20%;
- Staffing has been reduced by 10,000 (10% of total staffing) with 4,500 (45%) of this coming from cuts to nursing/midwifery posts;
- 2159 public beds (acute/non acute) remain closed; and,
- The number of patients inappropriately placed on trolleys, either in Emergency Departments (Trolley Watch) or as extra patients on already full wards (Ward Watch), has increased by 10.4% from March to September 2013 as compared to the same period in 2012 (full table attached).
Notwithstanding these cuts the health service has increased its productivity, and now stands above the international average for best practice in a number of areas including:
• Average length of stay;
• Number of day beds/cases to population;
• % of same day admissions;
• % of discharges within 48 hours; and,
• Number of patients treated, stabilised and managed in Medical Assessment Units (MAU’s) e.g. coronary emergencies.
The Government, in demanding this further €666 million cut, (which may run to €1 billion according to the CEO of the HSE), continues to insist on another 2,000 cuts in staffing numbers.
This is simply not possible and the only result, from this budget, will be the compromising of care as understaffed and overwhelmed frontline staff are unable to practice safely. It appears, despite all of the public comments, government ministers do not really understand the message coming from recent independent reports into incidents occurring in the health service. Safe care, through safe practice, will not be possible, as we move through 2014, because of understaffing and a shortage of beds and other resources. The health service cannot carry this further severe contraction and properly meet patient needs.
2) Public Health Measures (Revenue Raising)
The reality is the government, if it wished, could have generated the necessary revenue, to maintain our public health service, by bringing forward the following public health measures:
- €1 on packet of 20 cigarettes = €20 million;
- 30 cent on pint of beer/cider (pro rata with wine) = €100 million; and,
- 20% levy on sugar sweetened drinks (S.S.D.’s) = €60 million plus medium term reduction in costs, to the health service, from obesity associated illnesses – €200, million per annum.
These measures, which could begin to positively influence current lifestyles, have already been recommended by expert groups in their respective fields e.g. Irish Heart Foundation/Royal College of Physicians.
The government must therefore answer the question “Why are you cutting frontline health services instead of funding existing services from the revenue raised by these recommended measures?”
The vested interests, behind these industries, cannot be allowed to obstruct proper health planning, particularly in these most difficult of times. There is no excuse for real, damaging but avoidable cuts, being imposed on the health service, while these sources of revenue, which will bring about long term benefits to society, are left untouched.
Another alternative, in the context of a health service under such crippling strain, would have been to even marginally increase the temporarily lowered VAT rate on restaurants and hotels. A 1% increase would raise almost €100 million.
The INMO is holding a Special Delegate Conference, tomorrow Tuesday, in Croke Park, where the implications, arising from the proposed budget cuts, will be discussed by over 200 delegates in the afternoon.
Speaking this morning, INMO General Secretary, Liam Doran said:
“We have closely analysed the government’s actions, in cutting the health service for the 6th successive year, while failing completely to introduce positive, revenue raising, public health measures. The actions of government, in this area, are completely inexplicable, contrary to proper health planning and must be clarified immediately.
The health service in the frontline is now very efficient, but under real strain, due to lack of resources. It is not a ‘black hole’ and the government should not be swayed by others who, to protect their massive profits, resist any new/additional taxes or levies on their products even though they lead to cancer, obesity and anti-social behaviour.”
Mr Doran concluded:
“The INMO, in challenging this wholly inadequate budget, is seeking an immediate meeting with the Oireachtas Committee on Health to establish why this flawed approach has been taken and will be calling upon the government to revise its policies in these areas. We will also be seeking alliances with the other professional/expert groups who have argued for these public health measures.
It can never be acceptable, for any government, to put 50 cents on a bottle of wine while increasing, by €1, the cost for each item on a medical card prescription. There are alternatives and the government must think again.”