Irish Medical Organisation

IMO Calls on Government to Address Inequalities in Health- Budget Submission 2012

26 October 2011

Dr Ronan Boland, IMO President, at the launch of the IMO pre-budget submission Oct2011

See full text:  IMO Budget Submission 2012

Press Release 
IMO Calls on Government to Address Inequalities in Health and Access to Health Care

Health inequalities, access to Primary Care, Public Hospital Care, Long Term care, Lifestyle and the Prevention of Chronic Disease are the issues the Irish Medical Organisation are calling on the Government to focus on in the National Budget for 2012.
Launching the IMO Pre Budget Submission, Dr. Ronan Boland, President of the IMO said; “We are urging the Government not to make hasty short-term funding cuts but instead to focus on addressing inequalities in health and access to health care and to invest in initiatives that are budget ‘neutral’ which will lead to long-term savings.”
He said; “As the financial crisis continues, our members are increasingly concerned about health inequalities and the long-term impact the recession is having on lower income groups.  A wide range of factors - such as poverty, inequality, social exclusion, employment, income, education, housing conditions, transport access to health care, lifestyle, stress - all impact significantly on an individual’s health and wellbeing.  Evidence shows that lower socio-economic groups have relatively high mortality rates, higher levels of ill health and fewer resources to adopt healthier lifestyles.”
In view of the large contribution social determinants make to the health status of the population the IMO have outlined a number of recommendations such as the establishment of a Minister for Public Health to oversee the development and implementation of policy to address the social determinants of health and ring-fenced funding for the implementation of a new public health strategy. 
Dr. Boland said; “Secured funding for Public Health is of vital importance, particularly in view of the Government’s plans to introduce universal health insurance – a funding mechanism which traditionally caters poorly for Public Health requirements.”
The IMO Pre Budget Submission outlined that; While employment in the health services has fallen since 2007 figures show that activity levels have been sustained and in some areas increased indicating that more is being done with less. However, for those reliant on the public health system, access to hospital care is becoming increasingly more difficult and overcrowding in Emergency Departments continues. In addition the number of children and adults waiting over 3 months for elective outpatient care has increased by a massive *58.3% since July 2010 and by 13.6% for inpatient care.*
Dr. Boland said; “Waiting lists are a major contribution to our two-tier system. 47% of the population still purchase private health insurance in order to side-step waiting lists.  While, the Minister for Health has established a Special Delivery Unit (SDU) in order to address hospital waiting lists, the IMO firmly believes that for the SDU to succeed, hospital capacity must reflect demand and adequate financial and manpower resources must be provided to cope with the throughput of patients.”
While the IMO has welcomed, in principle, the Government’s Plans to introduce Universal Primary Care and to remove fees for GP care at the point of access, the organisation believes that Government must ensure that Primary Care and GP services are adequately funded and vulnerable rural and deprived urban communities have adequate GP cover.  
In the interim the Government must guarantee that those who require GP care receive it. The IMO is calling on this Government to increase the income threshold for receipt of a medical card to the minimum wage to more accurately reflect levels of disposable income. 
Currently patients who have to pay the full costs of Primary Care may be deterred from seeking medical care,  increasing the risk of delayed detection of medical problems, with the likelihood of higher health care costs in the longer term.  
“Research shows that a strong primary care system is associated with good health outcomes and lower costs and can help meet the challenges of an ageing population and higher incidences of chronic disease.”
“Treating patients with Chronic Disease in Primary Care is Budget neutral, however the transfer of services from secondary to primary care must be accompanied by an equivalent transfer of resources,” said Dr. Boland.
In relation to long term Residential Care and the Nursing Home Support Scheme, the IMO have always maintained the view that this Scheme is unfair on many older people who have contributed to the health system all their lives through taxes and taking little from it in return.  
Dr. Boland said; “Patients enter long-term care only when all other avenues have been explored.  Older people and their families have often made Herculean efforts to stay at home for many years and often a family member has taken substantial time out of their working life to care for a relative at home.”
He said; “The principle of solidarity must be applied to the funding of long-term care where the cost is spread over a wider population and access to the service is based on need.”
The IMO is also calling for a cross-departmental approach for the promotion of healthy lifestyles and the prevention of chronic disease.
According to the World Health Organization (WHO), chronic disease accounts for 86% of deaths in Europe.  Approximately 80% of GP consultations, 66% of emergency admissions and 60% of hospital bed days are related to chronic diseases and their complications.  With Ireland’s ageing population and if current trends continue bed requirements will increase by 50-60% over the next 15 years. 
Certain lifestyle factors such as obesity, poor diet, physical inactivity, tobacco, alcohol and drug consumption are known to increase the risk of chronic disease.  Yet the OECD estimates that only 3% of healthcare expenditure is spent on prevention and public health programmes.
*Most recent figures available as of today (26/10/2011) show an increase to 61.5% for elective outpatient care since August 2010 and 19.4% for inpatient care.
For further information contact:
Maria Murphy
Director of Communications &
Public Affairs
Irish Medical Organisation
Tel. 01 6767 273

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