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    Anyone for health insurance??

    <h1>Doctors say private care not always better</h1>

    Dr Muiris Houston, Medical Correspondent

    The belief that private healthcare is superior to public
    healthcare is a myth, a group of senior doctors has said.

    In a position paper to be published next month, which has been
    seen by The Irish Times, the Doctors Alliance for Better Public
    Healthcare says "for-profit" healthcare drives up costs and may
    contribute to a worsening of the general health status of the
    population.

    Using an international comparison of healthcare systems, the
    paper compares amounts spent on private medicine with life
    expectancy and infant mortality.

    In the US, private medicine expenditure is 8 per cent of GDP
    with a life expectancy of 77 years, whereas in Sweden and Japan,
    with a private spend of 1.4 per cent of GDP, people live on average
    to 80 and 81.5 years.

    Both countries also have the lowest infant mortality rates in
    the world, while the US ranks 18th in a performance table of infant
    mortality.

    "Private medicine has limited ability to provide intensive care
    and may not be in a position to cope with complications arising
    from the treatment it has provided," the group says, noting that
    the private sector does not provide integrated rehabilitation for
    patients who have suffered a major illness.

    "The public versus private debate is driven by an ideological
    principle that private is always better," one of the authors said.
    "Current Government policy is ideologically driven on the basis
    that private healthcare is superior. However, we have major
    concerns about the level of care the private sector offers patients
    as well as its cost effectiveness."

    The alliance claims to represent a majority of GPs and
    consultants working in the health service. Its members include Dr
    √Čamonn Shanahan, chairman of the Irish College of General
    Practitioners, and Dr Orla Hardiman, director of neurology at
    Beaumont Hospital.

    The position paper, Myth-busting in Irish Healthcare, also
    disputes claims that sufficient funds are being spent on the health
    service. "According to OECD figures, up to 20 per cent of our
    health budget is spent instead on items which are paid for from the
    social care budget in other countries," it says.

    Referring to figures that suggest we have more nurses per capita
    than anywhere else in Europe, the doctors say that because nurses
    here undertake work performed by care attendants in other
    countries, the true number of nurses performing nursing duties is
    much lower.

    On the issue of A&amp;E services, the alliance says the crisis
    is caused by bad work practices.

    "Hospitals regularly refuse to accept critically ill patients
    from other referring hospitals even though the patients can only be
    treated in a specialist unit. Even though these are very ill
    patients who have been prioritised between consultants, they are
    refused admission because other patients are on trolleys in
    A&amp;E."

    According to the position paper, some of the main factors
    leading to overcrowding in A&amp;E are insufficient bed capacity;
    inadequate facilities for the long-term chronically ill; the
    inability of general practitioners to directly access essential
    diagnostic services, and poor integration of hospital and general
    practitioner services.

    HSE chief executive Prof Brendan Drumm told the Joint Oireachtas
    Committee on Health and Children last week there had been a
    significant reduction in A&amp;E waiting times as a result of the
    HSE's winter initiative.
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