Maev-Ann Wren explodes health spending black hole myth
It's great to hear the intelligence and clarity of Maev-ann Wren on the radio again. To my mind, she is a model to my mind of what campaiging journalism is all about. She was on Pat Kenny this morning talking about her report for the ESRI, which explodes the myth of a black hole in health spending. [See www.esri.ie for the full report, I have a small excerpt from the conclusion below.]Wren suggested to Pat that as a society we should decide to pay higher taxes for a better health service, rather than spending the fruits of the boom on second houses. Even Blair managed to gain support for tax rises for increased health spending, when it was properly explained how that money would be spent. Not pulling any punches, Maev-Ann went on to say that hospital consultants are overpaid in the current system. The full interview available at www.rte.ie for a limited period. Wren's book on the health service is a must read, available from amazon at this link and better Irish book shops. I wish her every sucess in her role in the new Vincent Browne publication, Village Magazine.
Excerpt from 'Health Spending and the Black Hole' by Maev-Ann Wren, special article in Quarterly Economic Commentary, Autumn 2004, ESRI, Dublin Ireland, excerpted from www.esri.ie.
Ireland has just begun the process of remedying a considerable and decades long deficiency in health and social service infrastructure. The resulting increase in capital spending on health has brought Irish public health spending per capita close to the EU average. However, when capital and current spending are disaggregated, it is apparent that public current spending remained below the EU average in 2002, the latest year for which comparable data are available.
Increases in current spending over the period from 1997 to 2002 could not deliver full value against this backdrop of capital deficiency. The pace of spending increase was also so rapid that it
presented difficulties for planners and administrators. Furthermore, the hospital system faced inflationary pressures which exceeded those of other areas of the public sector.
Unease about the quality of health spending is not without basis. However, arguments for health sector reform are not incompatible with acceptance that the sector requires increased
investment. The case for sustained investment in health care made in the 2001 Health Strategy and the related primary care strategy remains unchallenged. Without this investment Ireland will be unable to achieve the standard of health and social care of other northern European states. Its achievement at an acceptable ongoing current cost requires reform of the hospital system, along the lines advocated in the Hanly Report, further reform of how hospital doctors work and are remunerated, and of how patients access care. Developing a planned, transparent programme of investment in health care, with planned, accompanying increases in current funding in a reformed health sector would seem an appropriate agenda for agreement between the new Health Service Executive and the Department of Health.
[...]Improving the quality of domestic data would however assist in both domestic decision-making and international comparison and possibly even convince some black hole proponents that, to paraphrase, "it does make a difference how much money goes into health".
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