Plans to Privatise the Health Service, by Michael Wallace


Enda Kenny’s new Government, supported by a phoney opposition in the form of Fianna Fáil, will publish its plans for its first 100 days in office before the end of the month. For example, the programme for government contains a shocking new provision that will allow ‘under-performing’ public hospitals to be taken over by private companies. In effect, this means the privatisation of public hospitals that ‘fall short of undefined performance targets’ to be handed over to the management of private for-profit operators.

In a speech last November, former health minister Leo Varadkar said that public hospitals who “consistently underperformed in respect of clinical outcomes, patient experience, and financial management should be ‘temporarily’ transferred under the management of a private company.” Varadkar’s comments were criticised at the time by FF spokesperson Billy Kelleher as “an extraordinary agenda that even Mrs Thatcher would not have dared to advance.” As with their promises on abolishing Irish Water, this has turned out to be pure electioneering from Fianna Fáil and they have now given their backing to these Thatcherite plans after all.

The new health minister, Simon Harris (above) plans an internal market within the HSE by breaking it up into a new Health Commission ‘purchaser’ and Hospital Groups and other ‘providers’. This will mean buying and selling contracts. These contracts will have ‘targets’ attached where hospitals and primary care services will be paid on the basis of performance, monitored by a new ‘Performance unit’ section of the HSE. The National Treatment Purchase Fund (NTPF), a Fianna Fáil proposal, will also buy and sell individual patients who are waiting too long. All of these measures will add more buying, selling and billing to the public health service, all of which, despite government claims to the contrary, are known to raise costs but not standards of care. What they do is to introduce a market where for-profit care can be more easily introduced. This ‘marketisation’ and ‘monetisation’ are just the relatively new and stealthy forms of ‘privatisation’.

The reason public healthcare is in crisis is that successive FG and FF-led governments have hammered the service with vicious cuts in funding, staff numbers and bed closures. Right-wing government austerity policies over the last 8 years have imposed billions of euros in vicious cuts to funding, more than 10,000 health-workers including over 5,000 nurses were cut from the service and there were more than 1,600 bed closures. While FG and FF haggled over their negotiations, more than 8,000 patients were languishing on hospital trolleys across the country last month.

Both FF and FG are driving a deliberate neoliberal strategy to run down the public health service while pushing the private healthcare agenda as the solution to the inevitable increases in waiting lists and trolley numbers. It has led to a two-tier health system where people’s medical needs are treated based on how much money they have.

The privatisation of public healthcare in Ireland has long been the dream of FG, FF and their wealthy backers in big business. These new provisions in the ‘programme of government’ are an attempt to steer Ireland down the road of for-profit care controlled by private health insurance companies and private hospitals. This is also an attempt to mimic the privatised US health system, one of the most expensive and worst-rated health services in the developed world.

Instead of a nasty, neoliberal programme for a profit-based system that would cost more, provide less quality care and further widen the inequality gap in healthcare, we need a national health service that treats people according to medical need and not based on the size of their wallet.

Fine Gael’s Universal Health Insurance (UHI) was a miserable failure that FG did not cost or even attempt to implement because the for-profit model of healthcare is too wasteful and costly. UHI would have cost more than €4,000 per person (including children) to fully implement. FG has quietly buried UHI but is pressing ahead with privatisation by other means. Any attempt by Enda Kenny’s new minority government, supported by his friends in Fianna Fáil, to privatise the publicly-funded Health Service will be met with massive resistance from healthcare workers, unions, patients and the public.

The establishment here have seen their plans to privatise water defeated by People Power and if they try to do the same with public healthcare, they will suffer the same fate.

Michael Wallace