Government should roll out 90 Primary Care Networks by end of 2015

• Government should roll out its proposed 90 Primary Care Networks before the end of 2015.
• As resources become available from Ireland’s recovery priority must be given to securing decent services in areas such as health and education.
• Essential infrastructure in areas such as social housing and disabilities should also be prioritised.
• Access to health care at any age should not be determined by the content of one’s wallet.

Government should roll out its proposed 90 Primary Care Networks before the end of 2015 if it is serious about providing a viable healthcare system across the whole country according to Social Justice Ireland's 2015 Socio-Economic Review.  These networks are a very good example of what should be prioritised as resources become available from Ireland’s economic recovery. These Networks would benefit the entire community and in particular older people, children and people with disability. They would go some way towards mitigating the income and service losses endured by Ireland’s most vulnerable since the crash of 2008.

The 343-page Socio-Economic Review, titled ‘Towards a Just Society: Securing Economic Development, Social Equity and Sustainability’ argues that “…decent services in areas such as health and education and essential infrastructure in areas such as social housing and disabilities should be prioritised by Government.”

The Review goes on to state that “There is a definite link between poverty and ill-health.  People’s health is influenced by factors such as poor housing, food security, unhealthy early childhood conditions and poor educational status”. 

National evidence shows that there is a widening health and social gap amongst Irish children by the time they are 5 years old.  A recent international study confirmed that Irish adolescents from the lowest socioeconomic groups are more likely to suffer from poor health, and Ireland ranked 33 out of the 34 countries studied on the difference in body mass index between poor adolescents and their better off peers.  We must invest in preventative measures and universal primary care to narrow the health and social gap and to ensure that our healthcare system does not worsen inequality.

Social Justice Ireland believes that healthcare is a social right that every person should enjoy and that people should be assured that care is guaranteed in their times of illness or vulnerability. This is going to become more challenging in the years ahead as Ireland’s population ages.  However there are significant areas of concern that must be addressed in the years ahead to ensure that every person has access to essential healthcare at all stages of the life cycle.

The development of 90 Primary Care Networks across the country, each with about 4 or 5 primary care teams (PCTs), could have a substantial positive impact on reducing problems the healthcare system currently faces and which, among other things, are putting huge pressure on accident and emergency services in acute hospitals. PCTs would, in effect, be one-stop shops providing a wide range of health services at local level.  They should be the basic building block of local public healthcare provision.

Ireland has a very underdeveloped system of primary care.  This results in significant pressure on the acute hospital system and a two-tier system of access to public hospital care which means that private patients have speedier access to care.  The Government target on public waiting lists is that the waiting time for treatment or out-patient appointment should be no longer than 15 months by the end of 2015.  This is extremely unambitious and completely unacceptable.  Very long waiting times have a disproportionate impact on those patients reliant on the public health service.  Access to health care at any age should not be determined by the content of one’s wallet.

There will be nearly 1 million people aged over 65 by 2031 an increase of more than 86% or an extra 20,000 people per annum. The old age dependency ratio (the ratio of those aged 65 years and over to those 15-64) was 17.3 in 2011 but is projected to rise to 30 by 2031.  These numbers highlight the need for long-term planning and investment to ensure that our health service can provide the care and services that will be required at all stages of the lifecycle into the future.  Central to this must be increased support for community-based services to support older people in their own homes/communities and the provision of capital investment to replace or refurbish community nursing facilities. 

Vision of Ireland

In this Socio-Economic Review, Social Justice Ireland spells out its vision of Ireland as a just society in which human rights are respected, human dignity is protected, human development is facilitated and the environment is respected and protected.  It argues that Ireland’s core values should be human dignity, equality, human rights, solidarity, sustainability and the pursuit of the common good.

Having these as guiding values would, according to Social Justice Ireland, ensure that Ireland became a nation in which all women, men and children have what they require to live life with dignity and to fulfil their potential: including sufficient income; access to the services they need and active inclusion in a genuinely participatory society. The Review goes on to identify five key areas for policy development that must be addressed if Ireland is to become a just society. These are outlined in the chart below.

Policy Framework

The Review provides details of Social Justice Ireland’s main conclusions and proposals on the following policy areas, each of which has a full chapter in the Review: Income Distribution (chapter 3); Taxation (chapter 4); Work, Unemployment and Jobs (5); Public Services (6); Housing and Accommodation (7); Healthcare (8); Education and Educational Disadvantage (9); People and Participation (10); Sustainability (11); Rural Development (12); The Global South (13).  Chapter 14 addresses the issue of Values.

The full text of Social Justice Ireland's Socio-Economic Review 2015, titled ‘Towards a Just Society: Securing Economic Development, Social Equity and Sustainability’ may be accessed here.