Thirty-five years-ago our Strabane home was struck by tragedy. In February my 58 year old father was diagnosed with terminal lung cancer just as he was about to retire from Dupont. Then in April my youngest sister was involved in a serious car accident putting her in a coma for six weeks and on a long road to recovery. They both received the exceptional care we expected from the Health Service and we are still, today, so grateful for that. Cancer care was yet to arrive at the Cancer Center at the City Hospital, back then it was provided, I think, at Knockbreda. My sister, due to the extent of her injuries, was immediately transferred from Altnagalvin to the ICU at the Royal Victoria. At the time another sister and I were living in Belfast with young families so our parents could stay: for my father’s chemotherapy and to visit my sister.
We had excellent support from Dupont who told us that as an employee my father had private health insurance which would improve his care. They looked into the benefits but found none. He had been a smoker and for some other reasons his cancer treatment was not covered. Likewise, my sister, then living at home, and who was therefore covered by the health insurance plan, did not have cover for a serious car accident.
As a result of this I became cynical about health insurance and as a strong advocate for the Health Service and the principles that underpin it, I vowed never to take out private health insurance.
Things have changed since the early 1990s. It has been difficult enough, even for those of us whose day job is providing services, to appreciate what has happened since around 2012, never mind the public who, as a result, have been slowly and surely deprived of a quality health service they have a right to.
In the years of Conservative austerity and up to 2015 I had some insight to what was going on but largely incapable of doing much. Off course our local Commissioning groups had passionate deputations from all the vested interest groups; each thinking they were somehow special and exceptional. With an annual cut of 6% to the Health Service budget when the service needed a minimum of a 6% investment to stand still, over a decade and up to the Covid Pandemic, the service was decimated to the point that waiting lists across the service became a major public health threat and remain so. Only so much salami slicing can happen before cuts start tearing the service apart.
The public have been surprisingly complacent and accepting of all this.
Transformation was the offered solution; inefficiency, not lack of funding, was the problem we were told. The Compton Report was a first attempt at transformation but was largely ignored by our politicians so we had a political version of transformation from our then Health Minister Michelle O’Neill which was ignored by all the other politicians before we got Bengoa. Transformation might improve efficiencies but lack of investment had eviscerated the service, and transformation was too slow, rendering efficiencies largely irrelevant.
Our politicians consistently failed to support transformation as they plugged into and amplified extreme public concerns about lack of services in remote cottage hospitals. So, in all the wrangling transformation was largely squandered and we are now faced with a diminished service that is sadly no longer fit for purpose. I accept transformation will still have a role but it cannot now achieve what it could have achieved ten years ago.
The real agenda, the real objective back in 2012, was part-privatization of the Health Service and its now near completion – a hybrid service. The only solution to waiting for a GP appointment or a hospital procedure is to seek out a private solution. We are all mostly doing it and the private sector is growing exponentially year on year.
Politicians without exception claim to be bulwarks for the Health Service. It’s what the public expect them to say but they are largely disingenuous realizing that the public don’t care about the Health Service they only care about getting what medical services they or their family need at a time of crisis. And if they can’t get it, appearing on the BBC will probably deliver it. Otherwise, the Health Service is ignored like the water in the well.
I am still without health insurance and I have just had hand surgery on the Health Service. I have been waiting over 5 years and when I finally got a call it came from a private provider who could do it the next day. The waiting list had been transferred out to get rid of it. The day procedure and follow-up for what is largely a genetic condition, and certainly not life threatening, was excellent. My brother who lives in Co Kildare shares the same genetic malfunction but since he’s younger it is now only becoming an issue for him. He visited his GP, got a referral and had the procedure in 4 weeks. No waiting list. Yes, he has health insurance but that is part of the national system which ensures equal cover for those who are not able to afford health insurance premiums.
Over the last 5 years as my right hand became less and less useable, I was goaded by friends and family to get a private procedure done. Go on you can afford it; you miserable git. It makes total sense they insist which confirms to me that the agenda of part-privatization of our Health Service – a hybrid service – is here and here to stay. I am unhappy about this. When we change the principles of our Health Service by stealth, we widen health inequalities and our Health Service begins to looks more and more American. Believe me, that is not a good look.
My father, in spite of great care, died in October of that year. With a stage 4 carcinoma of the lung, it was not going anywhere else. My sister, who sustained appalling injuries, thanks to the skill of the surgeons, nurses and physios made a more or less full recovery, went onto have a family of three great kids and will soon celebrate her 30th wedding anniversary.
I am a pharmacist in Belfast.
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