Healthcare demands equality - Village Magazine

36 December-January 2014

EALTH is life-deﬁning. We all experience ill-

health during our lives and need health services.

Health inequalities are reﬂective of injustice and

inequality in society. Austerity has exacerbated this

injustice and deepened these inequalities in Ireland.

Three studies have recently been published which

examine the impact of austerity on access to health

services and the impact of geography on cancer survival

rates. A common thread through the research studies

is inequality – of access to health services and of health

outcomes in cancer survival rates. Health inequali-

ties refer to the diﬀerences in the experiences of health

among diﬀerent sections of the population. Although

some people will live longer healthier lives due to genetic

or hereditary factors, health inequalities refer to ine-

qualities which are unnecessary, unjust and avoidable,

and could be addressed through public policies.

The European Foundation for the Improvement of

Living and Working Conditions research on ‘Access to

Healthcare in Times of Crisis’ found that the economic

crisis has had a negative impact across Europe on access

to healthcare services not only because of budget cuts,

but also because access to healthcare for households

has been reduced when their disposable income has

declined, creating new barriers to diminished health

services. In Ireland, the ESRI budgetary analysis has

previously illustrated the disproportionate eﬀect of

successive austerity budgets on low-income families,

which are also particularly dependent on the public

health system and therefore most aﬀected by cuts in

health services. The situation in Ireland thus presents

a particularly acute case in the European context.

The funding of the Health Services Executive (HSE)

was reduced by €3.3 billion (22%) over a four-year

period, 2009-2013. Health staﬀ levels have been cut

by approximately 10% since the 2007 peak. The health

system was able to ‘do more with less’ to a certain extent

in the early years of the cutbacks. However, in more

recent years it has been more a case of ‘doing less with

less’. This is evidenced by the growing numbers of peo-

ple on trolleys in emergency departments, increased

waiting times for public appointments, and the removal

of medical cards from signiﬁcant numbers of people.

Alongside this there has been a growing trend towards

cost-shifting by Government to individuals and fami-

lies through the introduction of, or increase in, charges

and thresholds for reimbursements (illustrated in Chart

1). In 2013, cost-shifting meant that on average every

person in Ireland was paying about €100 in additional

costs for care and prescribed drugs (Lancet, 2014). This

cost-shifting further worsens the inequities in access to

health services by low income families.

Fund it better

and distribute it

on basis of need

only, not wealth

Healthcare demands equality

SINÉAD PENTONY