Prognosis is poor for health service reform

You can really only appreciate the scale of the crisis in our health service when you experience it for yourself, be it personally or through the eyes of a sick friend or relative.

The main problem with our hospitals is not the standard of care provided by those in the medical profession - it’s trying to get access to it. While there are always exceptions, in general I have found the quality of our medical professionals - from frontline ambulance crews to nurses, junior doctors and consultants - second to none. In particular, I will always remember how well we were treated when our children were born in Holles Street and the immense gratitude I felt towards the competent and caring midwives.

But not all of my experiences with the health service have been so positive. I have seen elderly relatives left languishing on hospital trolleys and have endured long, painful hours in chaotic A&E departments in the presence of aggressive drunks and drug addicts.

There is a serious case to be made for segregating those presenting to A&Es with alcohol related injuries. Unless there is an obvious risk to life, they should be made wait the longest for treatment so genuine cases can be prioritised by hospital staff.

Like so many others, inordinate public waiting lists have forced members of my family down the road of private consultants where they have paid extortionate sums for 10 minutes of their time. Some private health insurance policies seems to only cover a small portion of the fee these days.

In reality, our two-tier health service is pushing patients down the private route due to the fear factor. People who are rightly worried about their symptoms don’t want to be waiting for a year or more to see a specialist under the public system.
 
But doesn’t it seem wrong that you can see this same consultant - sometimes within a matter of days - if you are willing and able to pay for it?I’m no expert on health sector reform but would it make sense if consultants were made to choose between their private and public practices? Surely more time solely devoted to public patients would help take the pressure off hospital waiting lists.
 
The other side of the argument is that consultants may well opt to exclusively concentrate on their lucrative private clinics, creating a dearth of medical expertise in the public system. It’s a difficult circle to square.

Given the chaotic system he has inherited from his predecessors, it’s unlikely that current Minister for Health Leo Varadkar will be able to magic up any quick-fix solutions this side of a general election.Chances are he’ll be leaving the Department of Health in the same sorry mess he found it in. He has less than one year to prove us wrong.

Time to end discrimination in rental market

Is renting the new buying? Are we about to dispense with our national obsession with owning our own homes and adopt a more European attitude when it comes to long-term renting?

With stringent new lending requirements introduced by the Central Bank, purchasers are going to find it increasingly difficult to find a 20 per cent deposit in a resurgent property market. First time buyers will have to stump up 10 per cent for properties costing up to €220,000 (and 20 per cent of the balance above that). 

This well-intended measure, designed to avoid a new property bubble, is going to push many families and individuals into the unforgiving world of our dysfunctional rental sector. 

Dubliners will bear the brunt of the pain for the privilege of living in the capital. Understandably, the country’s working majority need to be close to their jobs or at least within reasonable commuting distance.

With the recovery in house prices in Dublin, there has been an exponential rise in rents. A quick search on a leading property website lays bare the grim realities facing renters. Prices can vary from suburb to suburb but it’s difficult to find a decent sized family home for under €1,300 per month, even in the less salubrious parts of the city.

Beyond the Pale and away from urban centres, it’s a different story. I have friends renting an idyllic rural property – a stone-fronted converted mill – for €400 per month. You’d be lucky to get a garden shed for that sort of money in Dublin.

Traditionally, we were always led to believe that it made no sense to rent. The conventional wisdom was: why pay ‘dead money’ when you could own your own home for less?

But we are now in very different times and prospective purchasers face a range of obstacles before they can get a foot on the properly ladder: risk-averse lenders; rising house prices; inadequate supply of new homes; and new Loan to Value (LTV) borrowing restrictions. 

From this crisis we will see the emergence of a new breed of long-term renter. Their children will grow up in rented accommodation without having inherited their parents’ expectations of owning their own property.

In the absence of a properly functioning and regulated rental sector, we have a long way to go before we can enjoy the standards and security afforded to many of our European neighbours.

In Ireland, some landlords have effectively operated a form of apartheid that discriminates against those on rent supplement and casts a slur on people in receipt of social welfare payments. The Government is finally bringing forward equality legislation this year that will outlaw the practice of specifically advertising for tenants who are not in receipt of rent allowance. While this is a welcome step in the right direction, will it go far enough in ending the appalling treatment of social welfare recipients? 

Local authorities also need to ensure that slum landlords are eliminated from the rental market by ramping-up their inspection programmes and taking enforcement action where necessary.

Security of tenure and measures to control the spiralling cost of renting are also areas that will require progressive political thinking if we are to offer future generations a viable, realistic alternative to home ownership.