Economics 16/05/2010: IMF on fiscal stability IV

So continuing with the IMF Fiscal Outlook report data, building on the three previous posts: Part 1 (here), Part 2 (here) and Part 3 (here), take a look at another wonderfully ludicrous myth perpetrated by the Irish Left: the Myth of Underinvestment in Public Health in Ireland.

The Myth of Healthcare has two parts to it: Part 1: "Irish Government has under-invested in Irish public health." Part 2: "We need to ramp up Health spending to achieve better services".

Hmmm:
The data above is taken from the paper that formed the background to the IMF report, titled “From Stimulus to Consolidation: Revenue and Expenditure Policies in Advanced and Emerging Economies”, Prepared by Fiscal Affairs Department, Approved by Carlo Cottarelli (30-Apr-10). My calculations cover GNP comparatives and ranked results, plus the change between 1990 and 2007. IMF reports changes between 1960 and 2007 and 1970 and 2007. I find these data problematic, because of a large number of gaps in the data for these years. In addition, I would have trouble comparing Ireland between 1960 and 1970 through 2007 to majority of the countries on the list, as arguably, Ireland was not a developed or advanced economy in the decades prior to 1990.

What the table above clearly shows is that:

• In 2007 Irish Government spending on public healthcare was 8th highest in the group of advanced economies, measured as a share of our income.
• Accounting for the size of the recession in Ireland and a lack of significant fall-off in public spending on health in Budgets 2009-2010, one can relatively safely assume that we at least retained this position in 2010.
• In terms of increases in spending, we are clearly nowhere near the bottom of the league. We recorded 8th highest increase in spending in the last 17 years of all countries in terms of GDP.
  
• We achieved second highest increase in spending as a share of national income in the sample of developed nations.
• Our increase in health expenditure as a share of GDP was 21.4% above the average for the group of countries. It was 107% (more than double) above the average in relation to our GNP.
• A large number of countries - marked in bold red - to my knowledge offer superior health services to their citizens compared to Ireland while spending less, sometimes vastly less, public resources on healthcare provision. This statement does not take into account that many of these countries have much older population than Ireland.
• Have the FF/PD Governments been any worse (or better) than other Governments in financing health expenditure increases (or dumping good money after bad, if you want)? I don't know - the data above cannot tell me quality differentials or efficiency of spend. But what I can tell is that until 200 we were spending less than the group average on health. In 2007 we were spending above the average (based on GNP).

The problem, of course, is that we cannot perfectly measure the output we get for the money we spend on public health. Alas, somehow, I know that any foreigner living in this country runs for the airport the minute they get sick, desperately trying to avoid HSE's kingdom. French, Italians, Germans, Belgians, Spaniards, Czechs, Dutch - you name a country within the EU - all have been dreading the need to face our 'centres of excellence' where medical staff needs to be reminded to wash their hands and lines of sick patients stretch the length of the lines to the infamous Lenin's Tomb's in the hey days of the CPSU.

It looks like, according to hard data, this adverse reaction is not due to the lack of cash in the health system...

Economics 10/04/2010: HSE fails children and families

Updated below

On several occasions last year I wrote about HSE failures to carry out its job and provide requisite follow up support for adoption process in Ireland. This week, the chickens came home to roost for our healthcare bureaucrats. Except, as is usual in such cases, it is not the bureaucrats who are bearing the cost of such gross failure to do their job, but ordinary families and children.

A disclaimer is due - this is not an academic analysis post. It is an angry post.

Since at least May 2009, HSE was on the notice that it is failing to comply with the documentation support required by Russian authorities in the cases of cross-border adoptions of Russian children. The Ministers for Children and Health were fully aware of the situation.

The problem is a simple one. After a Russian child is adopted into Ireland (or any country for that matter), the agency supporting the adoption (in the case of Ireland - HSE monopoly behemoth, plus a small organization relating to the Church of Ireland - PACT) must supply a report on how the kids are adapting to their new family and environs. It is a brief standardized assessment document and HSE is required to collect and transmit it to the Russian authorities. HSE has staff on its usual lavish pay who are responsible for doing the work. It has managers, on an even more lavish pay, who are responsible for making sure the process is adhered to. There is no nuclear science involved. Just a routine follow up.

Unlike PACT (which appears to be fully compliant), HSE has simply decided not to do its job. Yes, this is exactly what they did. Since May 2009 the HSE has failed to provide the Russian authorities and the Irish adoptive parents with any information as to when and how the HSE will comply with the international obligation. Adopting couples - years into the process and even those already approved by the Russian authorities - were stonewalled by the HSE. In other words - the usual practices of 'do nothing, say nothing' that marks HSE work in virtually all areas of its responsibilities has been applied.

Between 50 and 70 reports were not submitted to the Russian authorities over a couple of years, prompting last May a blacklisting of Ireland by Russian adoption agencies. The blacklisting was not enforced by Moscow in order to give HSE enough time to comply. 9 months later, with no progress from HSE, and actually nearly total stonewalling by HSE not only of the Irish families, but also of the Russian authorities, Moscow's patience has run out. Thus, last week, HSE regional bodies responsible for providing adoption support were blacklisted by Russia again, preventing hundreds of families from proceeding with adopting children.

At the same time, tiny PACT seems to have been able to do their job and avoid blacklisting. Despite not having all the vast resources of HSE nor the Department of Health.

I have no personal interest in the adoption process. But, like any normal person in the country, I have a general human interest in seeing families being able to adopt kids who are in the need of having a proper family. I do have a number of friends who either have adopted kids from different parts of the world or who are currently in the process of adopting kids (so I can see the great potential these fantastic people bring to the lives of formerly orphaned children). And as a fellow human being, I cannot stomach an unaccountable bureaucracy, like HSE, standing between these families, these kids and their dreams.

More than anything else in these times of the crises, the callousness, the laziness and the arrogance of some of our official bodies responsible for adoption highlight the need for a deep reform in this country's public sector. Those in HSE, who failed to do their jobs must be fired, barred for life from ever taking another public sector job and left pension-less, for their victims are the most vulnerable people in this world - innocent children and fantastic families that go though years of hard work to adopt them.


Update: per readers tip-offs (hat tip to B & A), The Minister for Children, Barry Andews TD has presided over the de facto closing of the intercountry adoption in this country. On his watch, China, Vietnam, and Russia all have either seen their adoption treaties with Ireland expire or not complied with. Mr Andrews was fully aware of the problems in the cases of Russia and Vietnam treaties since Spring 2009 and despite having assured the adoptive parents that the issues will be resolved has, so far, failed to do much about it.

The Adoption Board itself has apparent difficulties communicating with the adoptive parents and the broader public. The latest Annual Report the organization has bothered to issue dates back to 2008. This document represents the latest public communication from the Board available on its site. Done truly in HSE's best traditions of public communications, then.