Tuesday, June 26th 2017, the Community Platform and All Together in Dignity Movement (ATD) Ireland hosted a seminar on the “Health as a Human Right”, held at the Irish Human Rights and Equality Commission in Dublin. The aim of the seminar was to discuss the Community Platform’s “Six principles for an inclusive health policy” and the “Our Voices” project organized by ATD Ireland to give voice to the people most underserved by the current healthcare system in Ireland. It was attended by over 80 people from a wide of variety of organizations working to make health care more accessible, equitable, and inclusive for all citizens of Ireland, especially those living in poverty or other forms of exclusion.
The timing of the seminar could not have been more auspicious because it coincided with the publication of the “Slainte Care Report” of the Oireachtais (parliamentary) Committee on the Future of Health recommending a universal single-tier service where patients are treated on the basis of health need rather than on ability to pay. This recommendation is at the heart of the six principles. Roisin Shortall (TD), who chaired the Committee and spoke at the seminar, explained that the report is a response to public demands for change in the health system. These demands became evident in the last elections and led to cross-party support, making implementation a real possibility.
In opening the seminar, Pierre Klein from ATD posed the question of whether “we can find a way to implement transformation with people at the margins of the system and…not thinking of them just at the end of the process?” The speakers that followed described the dysfunctionalities of the current two-tier system, which is 60 years behind most of Europe.
Dr. Sara Burke of Trinity College Dublin University presented an overview of the development of the Irish health system over the past three hundred years, stating flatly that “not having access to care on a timely basis leads to death at an early age.”
Paul Ginnell of the European Anti-Poverty Network pointed out that today simply having a card does not automatically mean getting care. “If access is to mean more than being put on a waiting list,” he said, “then those entitled to universal health and social care will be guaranteed access within a set period of time.”
One of the central themes of the seminar was bringing into the discussion people from the margins of society, who are most negatively impacted by the dysfunctionality of the system.
The participants viewed a video of the “Our Voices” project which brought together over 40 citizens from Dublin inner city and Ballymun, including members of the Traveller community and people having experienced drug addiction. In discussing their experience with the healthcare system, these people pointed out that health is a lot about relationships and how you are treated by the people you meet in the system.
The opening remarks and video were followed by a “World Café” in which the participants discuss four key themes: social determinants of health, health systems we need, access to quality healthcare, and participation. There was a separate table for each theme, where participants were able to raise issues and recommend solutions, all of which were recorded on large sheets of paper by facilitators. The facilitators then summarized the findings of each table for all of the participants.
The World Café called attention to a number of important issues that need to be addressed, such as the detrimental effects of inadequate housing, unemployment, and lack of educational opportunities on health. In a closing panel, Ronnie Fay of Pavee Point Travellers Centre, added that 90% of what effects a person’s health stems from these factors, so “we should be talking about investing upstream in health and not just healthcare.” Another issue was the need to deal with drug addiction and mental health as a single problem rather than through two separate systems of care. It was also noted that health care professionals have finally begun to value community support but require a process of continuous consultation in order to ensure high quality service that meets people’s real needs.
In the closing session, panelists returned to the “Slainte Care Report”, asking “What now?” They all agreed that there are powerful vested interests that will attempt to dismantle the plan bit by bit. “I think that pressure must come from the public saying that we are not prepared to tolerate the inequality and inefficiency of the system,” said Roisin Shortall. The panelists called for a campaign and lobbying efforts that give voice to most marginalized citizens as well as the general public.
In September 2017, ATD and the Community Platform will inform all the participants to the Seminar about the follow-up which will be given to this work.
Article prepared by Victor Friedman, guest of ATD Ireland and friend of the ATD Fourth World Movement