Healthcare and spending

Sir, – Jim O'Sullivan (Letters, August 24th) cites the planned €75 million expansion of the private Beacon Hospital as evidence that there is no real commitment to the introduction of a single-tier health system. I'm not sure about that. The commitment may well be there. It may even be introduced.

But there is probably a well-grounded concern that a one-tier system will see a levelling-down rather than a levelling-up of our healthcare, in which case private offerings will always seek to meet the demand for better.

Declan Doyle (Letters, August 24th) points out that there are more than 900,000 people on public hospital waiting lists. Fintan O’Toole has written (Opinion & Analysis, March 30th) that 46 per cent of the population pays for an inpatient health insurance plan and that this allows faster access to healthcare than the other 54 per cent gets. Combining the statistics quoted by Mr Doyle and Fintan O’Toole suggests that about one in three people who rely on our exceptionally well-funded public health system is on a hospital waiting list.

Does anyone seriously believe that the well-resourced bureaucracy which presides over this scandal will do a better job of looking after the healthcare needs of 100 per cent of our population than it does for the 54 per cent of our people who currently rely on it? – Yours, etc,

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PAT O’BRIEN,

Rathmines,

Dublin 6.

Sir, – Irish public health expenditure, correctly measured as a percentage of modified gross national income, is among the very highest in the world. When the young age profile of our population is taken into account, our health system is the most expensive in the world.

Every single year, billions of euro are added to the health budget and many thousands of additional staff are recruited. The annual increases in Irish public health expenditure are staggering. We now have circa 130,000 public sector employees in our healthcare system; one in every 29 adults.

Is the money well spent? Vaccination programme aside, have we noticed a demonstrable improvement in health services delivered to citizens? The constant narrative is toward more government spending and the emphasis is unfortunately on outrage and division rather than factual evidence and acknowledgement of the policy choices of Irish governments to date.

Ireland’s high personal taxation on higher earners, low or no taxation on lower earners (almost one million workers are exempt from tax), our hugely redistributive welfare system and our high spending health policy decisions have not happened by accident. Governments in this country have delivered a genuinely social democratic society, with no almost no acknowledgement from an ever-demanding commentariat of the left. – Yours, etc,

MARK MOHAN,

Castleknock,

Dublin 15.