The crisis in our health service came dramatically to the fore in January of this year as the trolley count in hospitals rose to new heights once again. Last summer we had the medical card crisis as thousands of discretionary cards were being callously taken from many of the most vulnerable people, including children with terminal illnesses.

With every recession over the last number of decades the Fianna Fail/Fine Gael led governments used the opportunity to take the axe to vital social services and the health service in particular. The increase in health spending during the celtic tiger years was a catch up in reality for the cuts of the ‘80s before that.  The capitalist parties try to claim that the health service in overfunded by EU standards but the truth of it can be seen in an OECD report that puts Ireland near the bottom of a table of EU-15 countries for public health expenditure per capita ( health

Under the Fianna Fail/Green Party government, by January 2010, there were over 3,250 fewer staff and 1,500 fewer hospital beds than there was in September 2007. Since the Fine Gael/Labour government came to power there has been a further decrease of 2,724 nurses. The mantra has been ‘doing more with less’, however, it is clear that there is massive overcrowding, understaffing and that frontline staff in particular have been pared down to the bone.

People who have the least are being asked to pay more, with increased prescription charges, the increased in the drugs scheme threshold and a myriad of other hidden costs that are coming out of the woodwork. The burden on the public health service is increasing as the budgets are cut whilst the population rises and many who previously had private health insurance can no longer afford it. 385,781 people waiting for outpatient care, many older patients can’t get out of hospital because there are waiting lists for the ‘Fair Deal’ nursing home places and many non-emergency procedures have to be cancelled because of a lack of hospital beds.

James Reilly as Minister for Health last year declared that “We cannot afford this broken health system – we must reform it.” The Government claim that the system is ridden with bureaucracy and inefficiency and their conclusion is that the public system doesn’t work and must be privatised under the guise of the universal health insurance. However, the real inefficiency lies with the two-tier nature of the health system and the parasitic private health insurance industry which lives off the public system; it lies with the gross underfunding which does not allow sufficient provision of public primary care, mental care, and nursing home places to take the strain off the acute hospital beds.

Fianna Fail had a much more direct route to privatisation through Mary Harney’s co-location of private hospitals on public hospital land, but Fine Gael’s universal health insurance would be much more thorough-going and insidious.

The Anti Austerity Alliance must fight for a fully public single-tier health system – one funded through progressive taxation and free at the point of use, based on medical need, not on ability to pay. It should incorporate all health care needs from education, prevention, primary care, mental health, acute and emergency services, through to step down, nursing home and palliative care, provided in the most appropriate settings.

We must support health care staff in taking industrial action when necessary to defend and improve conditions for themselves as workers and for patients too. According to Dr Fergal Hickey, an emergency medicine consultant at Sligo General Hospital and spokesman for the Irish Association for Emergency Medicine, up to 350 people will die each year because of overcrowding in Emergency Departments. Frontline staff in particular along with communities and patients should have a major input into decisions on the reform of the system; the level of investment needed and how it should be targeted. Private interests and money must not be allowed to be come before the health and lives of the people.