The Recession and the provision of health and welfare services...

We are living through unprecedented times. The economy is in crisis. A thousand people daily are losing their jobs; up to a half million Irish workers may be on the dole by Christmas. The Government is borrowing huge sums of money just to balance the books. As a country we are living above our means.

Following the April budget, we are going to see both an increase in taxation and savage cuts in public spending. At times like this we have to protect the vulnerable in our society. The Government promises to do that, but what faith do we have that they actually will?

It strikes me that we live in a society where so many things are upside down. We spend billions on the Health Service and Education, far more money than we have ever spent before; yet few people would honestly say things are better than they were. Wastage and unproductive spending are massive problems in the public sector. Ask any nurse, ambulance driver or teacher about the layers of bureaucracy that clog up the service they try to provide. Take a look at the salaries paid to front line workers in health care; compare them to management and administrative salaries, and wonder at the imbalances.

The problem we all face as cuts in public spending bite, is that they will affect the provision of basic services. No matter what the Government tells us, the balance between the providers of services and the administrators will continue to be top heavy. Carers, special-needs assistants, ambulance drivers, nurses, home help; these are the services that must be protected. Yet they, not the office personnel who administer them, will be under the greatest threat as spending cuts take effect. A quick look at the newspapers this week reveals HSE plans to cut 600 acute beds, and recruit three new directors at salaries of €194,000 each. Something seems amiss.

The gap between rich and poor in our society is getting bigger. We must protect the worse off; yet how many people are putting off going to the doctor or the dentist because they can’t afford the fee?

I picked up a hitchhiker yesterday, he told me he’d just come from the dentist. Poor chap had just had two teeth pulled. Assuming the story he told me is true, and I’ve no reason to suppose otherwise, the dentist wanted €3,000 to crown the teeth; but since the patient was on a medical card, all he could do was pull them for free.

One of the best contributors to the health and wealth of our nation is education. Could this valuable resource be better used? Of course it could. Wouldn’t it make sense to include more emphasis on things like good mental and physical health? Are we not missing a major opportunity to improve the health of our nation by teaching our children how to better look after themselves?

Copyright © David Jones, 2009