Open Letter Nov 2021
Doctors for Universal Healthcare – Open Letter – November 2021
Who We Are
Doctors for Universal Healthcare is a coalition of doctors calling for the introduction of universal healthcare in Ireland. We are a diverse group in terms of age, gender, specialty and background. However, we are united in our belief that healthcare is a human right, and that Ireland deserves a universal health system in which high-quality care is available to all who need it, when they need it, based on clinical need and not ability to pay.
Challenges
Access to healthcare in Ireland is becoming increasingly difficult. One in five Irish citizens are currently waiting to be seen by hospital specialists. Some will wait years, resulting in worsening health and ultimately increased costs. General Practice is in crisis as GPs retire unreplaced, appointments are becoming harder to get and many towns face the looming prospect of no doctor at all. Younger doctors repeatedly have their contractual terms and conditions breached, working unsafe and illegal hours. Doctors feel that they have little ability to shape health policy and governance, leading to frustration and low morale. We are concerned that in the absence of meaningful investment and reform, healthcare in Ireland will become privatised by default, resulting in increased healthcare and societal costs and worsening healthcare inequality. The National Treatment Purchase Fund is one symbol of our shadow health policy - undermining public healthcare, as we bolster private healthcare.
Fundamental issues underlying these challenges include a complex public-private hospital structure and a lack of a universal entitlement to healthcare. Despite spending more on health than many of our neighbours, we remain the only nation in Western Europe without universal access to primary care and with significantly fewer hospital beds, ICU beds and specialists than other European countries. These shortcomings have been badly exposed by COVID-19.
The Future
The behaviour of a health system is shaped by the values upholding it. It is time for a national conversation about embedding a right to timely, good-quality healthcare in our health system. Universal healthcare is supported by the vast majority of the Irish people as well as all major political parties, but is still not a reality in this country.
Sláintecare brought hope to many doctors of reform leading to a one-tier, universal healthcare system in Ireland. However, this hope has been dampened by a lack of true commitment from politicians and civil servants, resulting in delayed implementation and disengagement of clinicians from Sláintecare. We are particularly concerned that, for many doctors, the word Sláintecare has been tainted by its use in a needlessly negative contract dispute. This is regrettable, as many doctors are strong supporters of Sláintecare's underlying principles of universal healthcare and resource allocation based on need.
The values of solidarity and equity have guided us through the pandemic. Moreover, COVID-19 has clearly demonstrated the ability of general practice and our public hospital system to adapt rapidly to challenges and to deliver high-quality care to meet the needs of the nation. If we choose to do so, Ireland can deliver universal healthcare to our citizens.
Reform will not be easy, but with resources, political leadership and genuine engagement with those at the front-line, it can be done. As outlined by the De Buitléir Report, the extrication of our public and private hospital sectors will take money and time. Sustained investment in hospital capacity is needed, not just to tackle waiting lists but to remove them once and for all. Stabilising and then expanding access to GP and primary care will require not only resources, but rebuilding trust between General Practice and the HSE and Department of Health. Our surgeons need access to theatre space in the public system. Doctors and our representative bodies must be involved in the change process, at all levels of the healthcare system. We must invest in our staff: security, pay, working conditions and - above all - respect.
We are a growing coalition of doctors, eager to deliver the change that our patients need. We are proud to work in our health system, which does vital work in people’s lives, every day. However, we and many of our colleagues want to work in a universal publicly-funded system in which healthcare is guaranteed to all, based on the values of community, fairness, and human rights.
– Yours, etc,
Dr DOMHNALL MCGLACKEN-BYRNE, Dr CHRISTINE KELLY,
Prof CLÍONA NÍ CHEALLAIGH, Dr MARK MURPHY,
Dr LAURA O’DOHERTY, Prof SUSAN SMITH,
Dr EOIN MURPHY, Prof ANTHONY O’CONNOR,
Dr EAMONN FALLER,
And Dr Rita Doyle, Dr Mary Favier, Dr Gabriel Scally, Professor Anthony Staines, Professor Orla Hardiman, Dr Suzanne Crowe, Dr Nóirín Russell, Mr David Orr, Professor Liam Glynn, Dr Sarah Fitzgibbon, Dr Naveed Abbas, Dr Adrinda Affendi, Dr Taciane Alegra, Dr Saied Ali, Dr Laura Barry, Dr William Behan, Dr Paul Bergin, Dr Sinéad Birrane, Dr Sinéad Brannick, Dr Dorothy Breen, Dr David Brennan, Dr Mary Buckley, Dr Ruth Carey, Dr Stephen Carroll, Dr Marie Casey, Dr Michael Cash, Dr Eoin Cashman, Dr Kieran Clancy, Dr Ciara Conlan, Dr Stephen Connolly, Dr Aoife Corcoran, Dr Ellen Juliet Cosgrave, Dr Orla Cotter, Dr Hilary Coyle, Dr Ryan Crawford, Dr Laura Cullen, Dr Anne Dee, Dr Ross Dormer, Dr Joseph Doyle, Dr Eimear Duff, Dr Carol Duffy, Dr Claire Dunne, Dr Emma Dunne, Dr Patrick Earls, Dr Sara El Nimr, Dr Aisling Fanning, Dr Sinead Feeney, Dr Laura Fennelly, Dr Bridgid Ferriter, Dr Sarah Fitzgibbon, Dr John Flanagan, Dr Stephen Flannery, Dr Aoife Gallagher, Dr Seán Garvey, Dr Rosemary Gillan, Dr Tina Gillespie, Dr Mary Greaney, Dr Sieneke Hakvoort, Dr Mairead Hamill, Dr Douglas Hamilton, Dr Kieran Harkin, Dr Colm Harrington, Dr Áine Heaney, Dr Samuel Holt, Dr Fergal Howley, Dr Niamh Humphreys, Dr Ralph Hurley O’Dwyer, Dr Eleanor Irving, Dr Paul Kavanagh, Dr Grace Kavanagh, Dr Barbara Kearns, Dr Alexander Kelleher, Dr David Kelly, Dr Maureen Kelly, Dr Niamh Kennedy, Dr Susan Keogh, Dr Bridget Kiely, Dr Sarah Kyne, Dr Peter Lalor, Dr Tadg Lehane, Dr Marc Lincoln, Dr Catherine Lynch, Dr Aideen Madden, Dr Rónán Maher, Dr Eleanor Marks, Dr Kathleen McDonnell, Professor Noel McCarthy, Dr Jamie McGettigan, Dr Thomas McGimsey, Dr Edel McGinnity, Dr Sinéad McGlacken-Byrne, Dr Aisling McGlacken-Byrne, Dr Aimée McGreal-Bellone, Dr Maura McLoughlin, Dr Lisa McNamee, Dr Maeve Montague, Dr Sean Montague, Dr Connor Montgomery, Dr Amy Morgan, Dr Niamh Mulryan, Dr Hilary Mulvihill, Dr Aoife Murphy, Dr Geraldine Murphy, Dr Ellen Newman, Dr Mei Yee Ng, Dr Chantelle Ní Chróinín, Dr Caoimhe Ní hÉalaithe, Dr Martin Nolan, Dr Emer O’Brien, Dr Niamh O’Brien, Dr Seán O’Brien, Dr Nicola O’Callaghan, Dr Blathnaid O’Connell, Dr Ruairi O’Connor, Dr Dympna O’Dwyer, Dr Peadar Ó Fionnáin, Dr Darren O’Gorman, Dr Amelia O’Keeffe, Dr Conor O’Kelly, Dr Sarah O’Mahony, Dr Andrew O’Malley, Dr Máirtín Ó Maoláin, Dr Eleanor O’Neill, Dr Karen O’Neill, Dr Máire O’Neill, Dr Mark O’Rahelly, Dr Daniel O’Reilly, Dr Peter O’Reilly, Dr Ciarán Ó Riain, Professor Brendan O’Shea, Dr Aoife O’Sullivan, Dr Peter O’Sullivan, Dr Sinéad O’Sullivan, Dr Jonathan O’Toole, Dr Sean Owens, Dr Conor Palmer, Dr Ana Paula Panigassi, Dr Caleb Powell, Dr Shane Power, Dr Aidan Quinn, Dr Shóna Reynolds, Dr Alexander Robinson, Dr Ruth Roseingrave, Dr Emily Rutherford, Dr Bríd Shanahan, Dr Roger Smyth, Dr Anitha Sokay, Dr Eoin Somers, Dr David Stokes, Dr Roy Gavin Stone, Dr Ellen Sweeney, Dr Niamh Thompson, Dr James Trayer, Dr Roisin Tully, Dr Liqa Ur Rehman, Dr Jane Uygur, Dr Susie van Baarsel, Dr Áine Varley, Dr Kathleen Walsh, Dr Geraint Warlow, Dr Philippa White, Dr Maeve White, Dr Hye Won Yang