If you walk, say, a kilometre in Central Dublin, as I do on almost a daily basis, depending on the hour you’re likely to come across at least several homeless people sitting on the ground, begging, sometimes two on every street or bridge. It’s a very visible indictment of our supposedly wealthy society, notwithstanding the fact one sees this in many cities around the world. The thing is, Dublin is a small city by world standards, and the solution is therefore relatively simple and the financial committment relatively small. The odd thing is, according to the RTE report quoted below, someone has been paying attention in that there are now some facilities available, but as happens so often in Ireland, the dots haven’t been joined up - there’s no money to fund their staffing and maintainance.
Seven homeless people died in Dublin in a two-week period over Easter this year and at the same time, Prime Time said, at least five major homeless facilities in Dublin were either lying idle or being under-utilised due to a lack of HSE funding.
A 30-bed facility in James Street was due to open earlier this year but remains closed, while in Brunswick Street only seven of 17 family units have been used since January.
Prime Time also reported that a new homeless service in Middle Abbey Street has been denied HSE funding for running costs and in Cork Street, an emergency accommodation facility for homeless people with special needs remains under-utilised.
In Bolton Street, the future of a proposed accommodation facility also hangs in the balance.
Responding to the report, the HSE denied there were cutbacks but said it was in negotiations with the Department of Health to get additional funding.
Would those seven people have died if these facilities were available? Perhaps. But if even one of them could have been saved then we should hang our collective heads in shame.
Press Release
Apr, 08
Launch of Social Health Insurance: Further Options for Ireland “There is an alternative to present crisis and cut-backs in Irish healthcare”
Launch of Social Health Insurance: Further Options for Ireland Report by The Adelaide Hospital Society on Wednesday, 16th April 2008 at Buswell’s Hotel, Molesworth Street, Dublin 2 at. 1.30 p.m.
There is an alternative to present crisis and cut-backs in Irish healthcare
“There is an alternative to the present crisis management and current cut-backs in our health system” stated Dr. Fergus O’Ferrall, Director of The Adelaide Hospital Society at the launch of a major Report Social Health Insurance: Further Options for Ireland published by the Society. “A comprehensive social health insurance system, which the Report clearly demonstrates is practical, feasible and affordable, would ensure equal access to medical care for every citizen based upon medical need not financial means” he added.
The Report establishes that a carefully designed comprehensive Social Health Insurance (SHI) system in the Irish context would provide for all citizens
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free primary care consultations and prescriptions at the point of need
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timely access to hospital consultants, upgrading access to healthcare services for the worse off people to that of the best off people
This would involve health expenditure as a proportion of GDP rising from 7.5% to 8.9% or an increase of €2billion in running costs. This would still leave Irish healthcare spending comparatively low in European terms. The great prize of proper healthcare for all and the ending of the ‘two-tier’ system (which results in such pain and even death forpublic patients as the Susie Long case demonstrated so clearly) surely requires a national commitment to these necessary financial resources.
Given that SHI involves a protected healthcare fund or funds in place of funding healthcare through general taxation, the evidence is that Irish people would be prepared to support the increase required as they would know that their healthcare payments would be dedicated to healthcare.
The Report sets out various options with the associated costs as stages towards a fully comprehensive social health insurance system. For example, full medical cards for all children (under 19) would cost only an additional €160million or an increase of just over 2% in real terms on current healthcare funding. Full medical cards for all the population would cost only an additional €217million.
Social Health Insurance: Further Options for Ireland describes in detail the capacity constraints which will have to be met in the Irish health system in the period up to 2020 (whether SHI is introduced or not):
· Ireland has relatively few primary care providers in comparison to other European Union countries at 52 GPs per 100,000 population (France has 164, Austria 144, Germany 102 per 100,000)
· Ireland has a very low number of acute beds per head of the population at 2.9 per 1000 (the EU average is 4 per 1000, France has 3.9, Austria 6.1, Germany 6.6, UK 3.7 per 1000)
· Ireland has 1.55 hospital doctors per 1000 (compared to EU average of 2 per 1000)
There is a need for a health investment programme which the Adelaide Hospital Society suggests be called ‘Health 21′ to meet current and future capacity constraints in the period up to 2020 involving estimates between €3.2billion and reaching up to €6.4billion depending upon assumptions made. A similar national commitment to that of Transport 21 (which involves over €30billion) is required in Health 21. Surely the healthcare of our people is as important as transport.
The Adelaide Hospital Society advocates that the reform of the Irish health system be built around the concept of social solidarity which means that each citizen contributes to the overall burden of healthcare according to their means and that each citizen accesses healthcare according to their need. This is the European social model which underpins the most successful European health systems in terms of health outcomes and cost. The principles of equity, universality, solidarity and quality are the agreed common values and principles of the European Council (see EU council Conclusions on Common Values and Principles in European Union Health Systems June, 2006)
My local Labour TD Joe Costello dropped in a pamphlet with, along with other useful information such as entitlements and tax rates, a handy pie-chart showing where Irish taxes will come from in 2008. Very interesting.
Stamp Duties 6%
Capital Gains Tax 7%
Excise 12%
Corporation Tax 14%
Income Tax 29%
Value-Added Tax 31%
Other 1%
Now I’d really love to see a handy pie-chart as to where it goes., or in the words of the title of one of Aidan Murphy’s poetry collections, The Way the Money Goes.
The EU is to consider introducing automated border-crossing facilities within the EU for EU citizens and the electronic recording of entry and exit dates of third-country nationals in and out of the Schengen area.
It used to be Ireland which aped the worst ideas of the US, five years after those same ideas had fallen from fashion and shown to be useless and a waste of money. Now it’s the EU’s turn.
I’ve good reason to be pro-European. In fact I’ve many good reasons, and I am all for the European project; but it appears that our mainstream politicians are being profoundly undemocratic in asking us to vote for something we couldn’t possibly understand.
The ball is in their court. Persuade me with reason, not obfuscation.
Re the dreary turf war between Luas and Irish Rail over Broadstone, which according to today’s Irish Times Luas and the RPA have won (sub. required), what a pity there isn’t the imagination in Dublin that the Brazilian city of Curtiba was fortunate enough to have in the person of Jaime Lerner.
With maverick flair and a strategist’s disdain for accepted wisdom, Jaime Lerner re-invented urban space in his native Curitiba, Brazil. Along the way he managed to revolutionize bus transit, awaken green consciousness in a populace accustomed to litter and blight, and change the way city planners and bureaucrats world-wide conceive what’s possible within the tangled structure of the metropolitan landscape.
With maverick flair and a strategist’s disdain for accepted wisdom, Jaime Lerner re-invented urban space in his native Curitiba, Brazil. Along the way he managed to revolutionize bus transit, awaken green consciousness in a populace accustomed to litter and blight, and change the way city planners and bureaucrats world-wide conceive what’s possible within the tangled structure of the metropolitan landscape.
If we had something like what is shown in this video in Dublin, I would happily say bye bye to my dream of free-at-access transport. as this would cover many of the benefits I had thought of.
Actually, we could do it very quickly, combined with some of the ideas in the video below. An 18 metre streetcar, manufactured by Wrights of Ballymena, is supposed to have been on test for the last year or so, though I haven’t seen any sign of it. See my Streetcars of Desire.
Anyway, Jaime Lerner does my heart good. I hope he does yours too. (Yes, it’s another TED video ;>)
RTÉ reports that congestion is costing Dublin Bus €60m a year out of a total subvention of €80m, according to a submission to the Joint Committee on Transport.
Bill McCamley, SIPTU worker director, said Dublin Bus also paid VAT on its subvention and these factors had to be considered when looking at the subvention.
He told the committee that in relation to private operators SIPTU had a pragmatic attitude but claimed that up to 50% of licences issued to private operators to provide a service on some bus routes in Dublin were not being used.
He claimed the private operators were sitting on their licences and in the meantime Dublin Bus could not develop a service on that route.
The Joint Committe on Transport looks predominantly a conservative lot, so I don’t hold out much hope, but if congestion costs Dublin Bus €60 million a year, and Dublin Chamber Commerce estimated in 2003 that congestion cost its members €3 billion, isn’t it time to think out of the box and create a free-at-access public transport system - if necessary incorporating private companies like Luas and other bus lines? If the figure was so high in 2003, it must be closer to €4 billion now. Anyone got up to date figures?
At least then the subvention would be supporting public transport, and not congestion.
If you’d like to read some of the arguments I’ve made so far, click here. Click on the headings to get the full article. And please do add your own ideas in the comments. Criticism welcome but refinement of my idea even more so.
