2014-04-22 - Socio Economic Review 2014 - Full text and cover - FINAL

Health stating that it will not be possible to meet fully in 2014 all of the growing
demands being placed on the health service (Wall, 2014).
Social Justice Ireland believes that the cuts of over €600 million imposed by Budget 2014
are not consistent with Ireland having a decent healthcare service characterized by
safety and high quality outcomes and we do not believe that the Budget targets will
be met. Furthermore, this places an impossible requirement on the health services,
particularly at a time of population growth and population ageing.
Budget 2014 envisaged the equivalent of a cut of a further 2,400 full-time jobs in
healthcare by end of 2014 58 , and this will inevitably affect frontline services that are
already struggling to deliver services on a day-to-day basis. According to the HSE,
there has already been a loss of the equivalent of 12,505 full-time jobs since
September 2007 (-11 per cent) (HSE, 2013). Between 2011 and 2012 alone, there was
a reduction of 1.7 per cent in nursing staff (Department of Health, 2013).
In addition, the very significant increase in prescription charges introduced in
Budget 2014 (from €1.50 to €2.50 per item) will present a significant additional cost
to many people, especially those whose medical conditions require several different
medicines such as older people. 59 This, along with a further increase in the threshold
in the Drug Repayment Scheme, will cause some people to avoid accessing the
medicines they need. The introduction of a GP visit card on return to work for
unemployed people (instead of retention of a full medical card) will exacerbate an
existing poverty trap, as some parents are afraid to take up a job and consequently
lose their medical card even though their income remains low. The ‘doctor visit
only’ cards can create problems because many people are in the unenviable situation
of knowing what is wrong with them but not having the resources to purchase the
medicines they need.
Social Justice Ireland believes these measures will most adversely affect people on lowincomes.
This is not compatible with a health-service characterised by quality and
equity. An international study of the Irish health system has noted the existence of
financial barriers to access to healthcare, especially among those just above the
threshold for a medical or GP visit card (World Health Organisation & European
Observatory on Health Systems and Policies, 2012).
58
And for reasons explained in the HSE Service Plan for 2014 such as recruitment already
in train for new services, this involves a gross reduction of 3,500 full-time equivalent
jobs in 2014.
59
For example, evidence from TILDA, the Irish Longitudinal Study on Ageing shows that
20per cent of people over 50 take five or more medications; nearly 50 per cent of those
over 75 take five or more medications (WHO and the European Observatory on Health
Systems and Policies, 2012).
170 Socio-Economic Review 2014