Creating Fairness in our Health Service

Speech by Alex White TD, Labour Party Conference 2013,

Killarney, Saturday Nov. 20th 2013

Thanks very much Chair,

It is my great honour to introduce this morning’s session on health.  As the Chairperson has said, the context is our party’s focus on fairness, equality and social justice.

Health policy has always been a crucial issue for us as a party. Going back through the decades, we’ve had leading Labour Ministers in this area. Brendan Howlin, now Minister for Public Expenditure and Reform – was an important policy leader in the 1990s.  He talked about primary care before anybody spoke about primary care.  Before him, Brendan Corish and right back, the Labour Party has always regarded health and health policy as being critical to what we want to achieve in our country.

I want to spend a couple of minutes this morning to dwell on the changes and the kind of challenges we have to deal with in health and in health policy. I think it is a big issue for the party and an important political issue.

In common with health systems all over the world, we have to address, and are now starting to address seriously at last, new, serious challenges such as ageing populations, which is a good thing of course. But we have to address how we configure our health services and most importantly of all, the creeping epidemic of chronic illness. This is literally a challenge that could bring the health service down if we don’t address it and address it properly.

Twenty-first century diseases and illnesses like diabetes are completely changing and altering the kind of health service we need for the future. The model of hospital-centred healthcare simply won’t work in the future. The politics of healthcare will therefore change I think.

So, of all of the debates we’ve had in rooms like this over the years about health – how often have they been dominated by debates, arguments and rows about hospitals and the closure of hospitals? That’s the case right across the board politically. It’s not about that anymore. It’s about how we configure the services, how we actually transform the services and how we think about a health system as one that can address the challenges of the future.

If we think the health system now is in a state, with all of the health cuts that have been necessary as a consequence of the economic and fiscal crisis, it will be many, many times worse in the future and conceivably in the near future if we do not radically alter the way we organise healthcare in Ireland. If we fail now to plan really fundamental change in the way we organise healthcare, I think our system will collapse.

It will collapse because of the sheer pressure of demand associated with the consequences of unchecked chronic illnesses and it will collapse literally because it won’t be possible to finance it if we continue with the current model.

Healthcare has to become the concern of the whole society, not just the concern of those who are ill, and those who care for them, but the concern of all of the population. Health has to be literally about health, and not about illness. Health has to be about staying healthy and not becoming sick. Health policy has to be about nutrition, fitness and exercise, addressing lifestyle factors such as smoking, excessive consumption of alcohol, what we eat and how we live our lives, taking control of our own health and managing our own health.

These are the kind of things people say all of the time. The debate is constantly about primary care of course. But the policy has to be redirected. We have to go beyond the funding of expensive hospitals, important and all as that is. We have to give priority to primary care. It isn’t just desirable, it’s absolutely essential.

This means care in the community, care and treatment by your GP, by your practice nurse, by a nutritionist. So it is a political question. What are we doing about that?

We are implementing the policy of universal access to primary care. The budget announcement, which is now being brought forward in the form of legislation to extend GP access to children aged five and under, is a hugely significant move but it’s just the beginning.

Yes we can see it as a real break for families.  But it’s not some kind of sop as the way it’s been characterised in some quarters.  It is the first step in the implementation of a policy of universal primary care to remove the barriers of fees for attendance at your doctor. It’s a public health measure and I’m proud to have worked with Eamon Gilmore and Brendan Howlin to deliver on this critical achievement.

Another public health measure is the alcohol strategy. For the first time ever we will have a public health focus on our alcohol policy in this country.

Ladies and gentlemen, we’re political people in this room. We have a shared vision for a better country, equality for social justice, transforming the way we manage and configure our health services is central to the achievement of that vision, so that people can have healthy and fulfilling lives. All of our people, not just those who can afford it.

Labour in Government is making real progress on this objective. Just like Eamon Gilmore said last night, our job is to deliver. We debate the issues here, but our job is to deliver in Government. To deliver universal access to essential primary care services, to deliver real public health initiatives such as the alcohol bill, to deliver long-standing policy objectives such as the X-case legislation.

We deliver in Government; that is where we make the changes we want to see.

Thank you very much.