All of us are adjusting to our new routines and trying to come to terms with the real threat posed by the Coronavirus pandemic. The thousands of deaths in Italy and Spain are grim reminders of what may be coming our way and a deadly incentive for us all to stop close contact with other human beings and to keep to the health directives which now govern how we live. It would be easy to be overwhelmed by all this. We all know someone who has the virus. We know we could be next. So we watch the responses of those in the three governments which rule us as we wait for the next news report or the next instruction.
Don’t make this political some readers may say. Why not? It is political. I don’t want decisions about the wellbeing of my family and friends to be made by a Jack the Lad in London who has vandalised the very health services which we are so dependent on. Neither do I want a caretaker Taoiseach without a mandate who did exactly the same thing when he was in power. Or his partner the Fianna Fáil leader who did the same thing. I can just about put up with the novel form of governance which we tolerate in the North because of our peculiar circumstances but I want change. Not footery, fiddley cosmetic change. Not spin. No! I want real societal change. That includes a real public health service alongside other public services.
If ever there was a need for decent health services, properly resourced and funded, this pandemic has provided the evidence for it. It has also demonstrated the folly of partition with its two health and economic systems on our small island. Add to this a decade of austerity policies by the Tories in London and by Fine Gael, Fianna Fáil, the Greens and Labour in Dublin and you have health systems already unable to meet the normal needs of citizens. Faced with a pandemic virus, which has required an unprecedented societal response, our two health systems have been fighting a desperate battle to provide the necessary health care to the growing numbers of citizens succumbing to Covid-19.
Last week along with millions of others across these islands I applauded the courage and selflessness of health service staff who are putting their lives on the line against an insidious viral enemy. Like most of you I know family members, neighbours, friends who go to work every day within our health system. They don’t see themselves as heroes. But that is who they are. Heroes, who deserve our solidarity and our thanks. They also deserve personal protection equipment that is fit for purpose and intensive care units and ventilators sufficient to meet the needs of their patients.
It is a fact that the Health Service in the North has always been underfunded. This has grown worse in the last decade under British conservative governments, supported by Unionist parties. As a result waiting lists have lengthened, and accident and emergency departments are under resourced.
In the South the two tier health service created and funded by successive Fine Gael, Fianna Fáil and Labour governments, and the austerity policies of these parties, created enormous gaps in health care provision. Acute hospital beds were cut, a moratorium on hiring nurses and health staff was imposed, and investment in the health service was slashed. Beds in Intensive Care Units were dramatically cut.
According to the World Health Organisation, the Irish state is “unique among EU countries in not providing universal coverage of primary care ... its system of entitlement to publicly financed healthcare is complex”. WHO concluded that: “This results in not only unmet need but also inequitable and inefficient patterns of use ... These barriers are substantial relative to other EU countries, especially for primary care.”
The OECD (Organisation for Economic Co-operation and Development) has made an equally damning assessment of the British health system.
The decision therefore by the government in Dublin to take control of private hospitals was belated but welcome. It would also be interesting to see the small print of that agreement. But it is only for the duration of this emergency. After the crisis is over the government’s ideological stance will return us to the status quo – a two tier health service in which patients must pay for access to GPs and receive bills for treatment in A&E departments.
It is this same ideological position that caused Fine Gael, Fianna Fáil and Labour’s failure to invest in public services. The Director General of the Irish Business and Employers Confederation (IBEC) acknowledged this last November. He cited as evidence the ongoing crises in housing and homelessness, the scandal of a health service, as well as deficiencies in childcare provision, public transport and education.
All of this led to a widespread public desire for change. This became evident in February when Sinn Féin emerged as the largest party in the state in the general election. The Coronavirus crisis has amplified this demand for change. It is now a constant and growing refrain on social media platforms, and in newspaper articles and opinion pieces. How often have you heard or read that things can never be the same again. That there must be change. That we can’t simply continue as before. That we have to change the way we do our politics. That this global crisis must lead to fundamental societal change – economic, social, health and political change.
Political decisions needed to protect families, secure jobs for the future, maintain a reasonable level of income have been forced on reluctant governments in Dublin and London.
Note however that the bankers and insurance companies continue to rip-off citizens. Note how those most likely to succumb to the virus are the elderly, the vulnerable, the poor, the homeless. citizens in Direct Provision, in nursing homes, in Traveller sites and frontline health workers.
There is a real danger that out of these hard times we will see the old order re-invent itself. Fine Gael and Fianna Fáil in government is not change. Remember how in the aftermath of the 2016 general election there was much talk of ‘new politics’, of a new way of doing things. Editorial and opinion writers and many political commentators wrote reams about the transformation heralded by this ‘new politics’. But thankfully citizens saw through this. It was all a scam – it was all a lie. The ‘confidence and supply’ arrangement between Fine Gael and Fianna Fáil was coalition by another name.
A Fine Gael-Fianna Fáil carve up coalition will just be more of the same. The spin will be different but the core conservative politics will remain unchanged.
So too in the North for as long as we are tied to Britain.
Irish republicans have a different vision of the future from the establishment parties. We are for a national republic – a new Republic. But we don’t have to wait until then to make change. We can insist here and NOW on the highest standard of services and protections for all citizens equally. We can demand parity of esteem and equality of treatment, opportunity and outcome. That’s what the Good Friday Agreement sets out.
In the here and now we should all be demanding real change which benefits citizens, protects working families, takes care of the disadvantaged, and invests in public services. That’s what citizens deserve. But that will only happen if we make it happen.
This is not pie in the sky. This is doable. Society on this island is already shifting. Changing demographics and political allegiances, new ideas and concepts, new leaderships are reshaping Ireland today. Let’s not allow the self-interests of the old conservative parties to dictate the limits of our potential or of our future. Let us argue for a real National Health Service across the island of Ireland with seamless and maximum co operation between both parts.
As we face into whatever distress and tragedy the pandemic serves up let us resolve that our health workers and carers will never again have to beg or borrow protective clothing. Let us resolve that our nurses will be properly paid and that there will be enough of them. Let us resolve that our doctors and patients deserve the best facilities. Let us resolve that our elderly and vulnerable citizens will have their rights. Let us resolve that heath service is one of these rights. It is not a business or a privilege.
And let us resolve that the best people to take these decisions for the people of this island are the people of this island. Not some Jack the Lad in London.