The Irish Hospital Consultants Association (IHCA) had already pointed out before the advent of Covid19 that it was ‘clear the Health budget 2020 . . . does not resource our public hospital and mental health lists’. Access to and the delivery of care for public patients have been characterised ‘by record numbers of patients being treated on trolleys, unacceptably long waits in Emergency Departments particularly for vulnerable elderly patients and increasing numbers of patients—now at one million—waiting many months and years to access care’.

That’s one million patients or so from a total population of 4.88 million waiting for access to public healthcare of one sort or another while our taxes subsidise private medicine.

In June of this year, Paul Cullen reports that at least 100,000 children are on a public waiting list for health appointments or procedures.

There are 82,264 children on the outpatient waiting list and 7,698 waiting for an inpatient or day-case procedure, according to figures from the National Treatment Purchase Fund. Another 5,000 children are on other public waiting lists, while another 8,000 awaiting scans are not recorded on an NTPF list, according to the Irish Hospital Consultants Association. . . . More than 37,000 children on the outpatient list have been waiting 12 months or more to be seen. More than 2,500 children have been waiting at least 12 months for an inpatient procedure.

The per capita cost of the Irish health service is more than the UK, Finland, Belgium, or France, about the same as Austria, Germany, and the Netherlands, and not that much less than Denmark and Sweden. All of those countries are lower down on at least one international rich list than we are. But they all get an awful lot more bang for their healthcare buck.

Among the reasons our money seems to buy so much less is the deplorable fact that one-third of what we pay for healthcare from the public purse is channelled through the private sector. Let me say that again. One-third of taxpayers’ money allocated to healthcare is spent on subsidising private hospitals so that higher-income earners with health insurance—including TDs and Senators—can skip waiting lists, improve their recovery rates and times, and take increasing advantage of preventative medicine paid for by our taxes.

The rest of us join waiting lists. And wait. While we wait, and as our conditions worsen, our money is subsiding the private medical sector. We have to stop doing that. And we have to make it clear to the Government that we have to stop doing that.


Similarly, taxpaying commoners subsidise private schools to which the great majority of us don’t have access. Carl O’Brien points out:

Department of Education figures show that during 2018, the State paid just over €91 million on salaries for teachers employed in fee-paying schools. In addition, capital expenditure funding, ICT and sports grants for private schools amounted to more than €1 million.

Private education is cheaper in Ireland than in the UK because the central economy over there doesn’t subsidise fee-charging schools. But over here, in a republic no less, the public purse is very generous to private schools, leaving income from fees available to pay for facilities and other privileges that State schools can’t afford. Ruairi Quinn, then minister for education, commissioned a report into the income of private schools in 2013. It estimated that fee-charging schools had more than €80 million extra a year to invest in additional support and facilities for their pupils.

Meanwhile, there’s no relief, so to speak, for those public schools in Ireland that don’t have indoor toilets.

It’s time we stopped letting the already rich and powerful get richer and more powerful at the expense of the rest of us in a rigged system.

Those private-school graduates, to whose education costs we have generously contributed, also get an important boost from the Government by way of so-called school profiling to make sure that the top places in the universities are filled by the ‘right’ people. The outcome is that private-school graduates disproportionately fill the various professions, take up a disproportionate number of places on corporate boards and government-appointed quangos, and provide a disproportionate number of Dáil members and government ministers. In short, those students, to whose expensive education we less fortunate citizens contributed through our taxes, are over-represented among the leaders and power brokers of our so-called republic.

What does €90 million buy these days? Quid pro status quo.


Rather than spend money on building public housing, our Government pours our hard-earned cash—almost €700 million in 2018, about €4 billion during the 32nd Dáil—directly into the pockets of private landlords through rent subsidy schemes that support overpriced, insecure, and insufficiently regulated tenancies. Meanwhile, upwards of 70,000 families are waiting to be housed. Some of them have been waiting for more than a decade. More than 8,000 people are literally homeless; one in three of them is a child. They survive but don’t thrive in emergency accommodation that’s a lot more emergent than accommodating.

Also in 2018, the Department of Public Expenditure and Reform baulked at awarding a 12% across-the-board pay rise to nurses that would have cost the exchequer around €300 million annually—less than half of the €700 million being sucked up by private landlords.

One in four Dáil members and almost one in three Cabinet Ministers in that Dáil was a landlord, and none was a nurse. Who’d have guessed?

As an aside, may I point out that it should go without saying that landlords should not write landlord and tenant laws? Ministers for Health, who determine how and where the health budget should be spent, should not have a financial interest in private healthcare facilities. The Minister for Education should not have a personal or financial interest in private schools. We urgently need robust conflict of interest legislation; TDs with personal, financial, or other interest in legislation before the Dáil must recuse themselves or be recused from legislating on that issue.

It’s time we stopped letting the already rich and powerful get richer and more powerful at the expense of the rest of us in a rigged system. Public waiting lists for medical treatment get longer as we shovel money into the private sector. Rich kids get a better education at our expense—and then the Government cheats on the Leaving Cert results to see that they get the top university places. Builders and developers move up a notch on the rich list with a massive assist from the Government, who will gladly pay market price rather than build houses themselves. And right now, up to three thousand children are being raised in single rooms in B&Bs on meals from the chipper.

Doesn’t sound very fair to me.