What I Hope to See in the Budget

Our country, the world, has been rocked by the COVID-19 pandemic. This is having an enormous impact on economies, bringing many nations into recession. The one solace is everyone is feeling the impact. It has the knock on effect of reducing the income of the country, ending in a reduction in taxes. Thankfully Ireland entered this downturn with a robust economy and we all hope we bounce out of this quickly.

This new ‘normal’ has affected the MS community. Restrictions were put in place on access to Occupational and Physical therapies, and during the lockdown the only way to get this help was in hospital. People stopped exercising with enormous affects on health; I lost some of my mobility, as a result. Now we are trying to recover what we lost. 

A well designed and creative budget this year will bring us back to how we were in 2019. We do not want to return to the austerity measures. This was devastating, and we made many mistakes. 

This cannot happen again.

In the upcoming budget, I would like to see the government address the following issues.  

1. Funding for Charities

Organisations like the MS Society depend on fundraising to provide services which are not available through the healthcare system. The MS Care Centre is one example of a service which has proven beneficial to many people with MS over the years. This is at risk of reducing from the 40 weeks it opens to something much less, as the usual bucket collections and fundraising events have been restricted because of the pandemic. The society will find novel ways to replace the old events, such as the Virtual Balloon Race, in time, but they need the funds now. 

2. Funding for Health Services

COVID-19 stopped all community services as the country prepared for the surge in hospitalisations. These need to be re-instated and funding put in place to bring the services to a level where waiting lists are a thing of the past. This pandemic has shown the government can take swift and decisive action when faced with an enormous challenge. Our health services have been under funded, this crisis highlighted that. Now is the opportunity to reduce the lists, get an appropriate level of healthcare professionals, to ensure waiting lists are a thing of the past. 

The pandemic has shown the need for a robust health service with spare capacity. 

3. Electronic Health Records (EHR)

I have attended several health related conferences over the last 3 years and every time we discuss EHR's, its need in Ireland accepted, and still we do not have something in place. Maybe I am being naïve, but many countries have implemented this, successfully. Why has this not happened here? Lack of will? The technology is in place, and the pandemic has shown how we must use the technology we have available. 

This will have a positive impact on healthcare, enabling patients to see their complete health records in one place. Every healthcare worker will then have a complete picture of the patient, the progression of their condition or conditions, medications and therapies tried. If designed correctly the health services will have an accurate picture of the health of the nation, not relying on surveys, or samples, but on the actual data.  

4. Reform of Social Welfare Payments

We have several payments for people with long-term illnesses;

1. Disability Allowance 
2. Illness Benefit
3. Invalidity Pension
4. Partial Capacity Benefit

This is very cumbersome and puts people with illnesses in a precarious position. Our illnesses are challenging, and to have to worry about our income is another worry. For some reason, these payments are based on employment. They should be disconnected from that system. Disability and illness comes with extra costs and health variability. I believe one payment should be available for people with long-term conditions which permit them to work. An extra wish is any money earned from participation in research on medicines or therapies should not affect Social Welfare payments. 

5. Change in Healthcare Funding

The health system funding is based on either hospitals or community, and each county or region has its own budget. This creates situations where someone in one region can get funding for a wheelchair now, whereas others must wait for months. This inequity must change. My suggestion is the health system should allocate a budget (a heath credit card) for each person. This budget would change if they diagnose the person with a particular condition. Then this person can spend this health credit card with whomever or on whatever they choose. This will resolve many problems with the health service, and will give control back to the patient. It will also have the added benefit of know how much ill health costs, and could push the government into preventing long-term health exacerbation by treating the illness early.

Conclusion

This pandemic has highlighted the weaknesses in our social welfare system and healthcare systems. The spotlight is on them now, and now is the time to instigate true and comprehensive reform. It would be a fantastic outcome of this challenging time if we, as a nation, could transform how government services are delivered.