New Ireland: New ideas by David Puttnam, Dermot Desmond, Catherine Motherway and more

Published date19 June 2021
Date19 June 2021
Publication titleIrish Times: Web Edition Articles (Dublin, Ireland)
Healthcare

Catherine Motherway – Intensive Care physician

Healthcare is a finite precious resource that we need to use wisely and be prepared. The experience of the last 18 months can help us shape a better service.

Public health: Following public health guidance is key to disease prevention during Covid. We need to continue with disease prevention in our population. Obesity, diabetes, drug and alcohol abuse are significant adjustable risk factors for cancer and many diseases. The burden of these diseases can be mitigated if we follow advice as we did in the last 18 months

Healthcare capacity: We entered into this crisis with one of the lowest critical care bed-to-population ratios in Europe. The pandemic exposed this as one of our serious vulnerabilities. We managed to temporarily increase capacity from 255 to over 350 staffed beds. The effort of many (staff, and the population's adherence to lockdown) prevented our system from being overwhelmed but at the expense of deferral of scheduled care. A doubling of our bed numbers is now promised by politicians. This should support high risk elective work and ensure we operate at 70 per cent capacity allowing for future surges in demand.

Decision making in healthcare: We must continue to foster a combination of local decision making within agreed collaborative governance structures. Local leaders, given the space and time, can find local solutions with the clinical programmes and the backing of frontline staff. Groups like the Medical Leaders Forum meeting with the chief medical officer, Minister for Health and Department of Health should continue to shape how we plan our new Ireland health service.

Digital innovation: The increased use of IT for virtual consultation and communication should continue. While in-person consultation will still be necessary, in many instances, virtual follow up in the patient's own home without the need for travel will be welcome. Staff training opportunities can now be accessed online and virtual meetings bring international expertise together.

Staff wellbeing, recruitment and retention: The key to healthcare is staff. They need to be supported, respected and valued in their work, have access to training, education, research opportunities, psychological support and must have sufficient numbers to deliver quality care. Access to affordable housing, and transport to their workplace is vital. Their views and requirements need to be respected and facilitated. A true cultural change which is patient focused and staff friendly will reap rewards.

Housing & property

Dermot Desmond – businessman and investor

Dublin has the highest rents of all EU capital cities. A starter home in Dublin is twice the cost of one in Belfast. We must rectify this by deflating prices for zoned land and controlling selling prices.

Irish housing policy has concentrated power among a small number of institutional developers to the detriment of the small builder and competition. Site ownership is corralled and planning permission hoarded to the detriment of housing supply. Apartments are left empty for protracted periods for fear of putting downward pressure on rents, while developers are allowed to sit on planning approvals granted. Simultaneously the State is inflating prices by guaranteeing rents, overpaying for social housing, utilising the SHDs (strategic housing developments) to reduce the quality of housing while protecting developers, and transferring public lands to private ownership.

We must cease using tax benefits to seduce foreign institutions into purchasing Irish homes at inflated prices. The following measures should also be taken . . .

Planning permission: All planning permission should include conditions that require work to commence within one year of grant and work to complete within three years. The practice of requiring large-scale issues to be agreed as conditions to the permission subsequent to its grant should be discontinued. Where there is any breach of conditions the State should retain the right to impose the cost of default on the developer and the right to have the work completed

Vacant property levy and tenant lease breaks: Where a landlord owns more than five rental properties, a vacant property charge equal to 50 per cent of the market rent should be levied if the property is vacant for more than three months. This would impact all professional landlords, including tax-exempt institutions. (Allowances would be made for significant renovations on older buildings). Tenants should be enabled to break all residential leases on three months' notice, thereby ensuring landlords are not charging above market rents. Similarly, the State should have a right to impose an increasing levy if zoned residential land is not being developed.

Utilise State land: The State should become directly involved in the master-planning and building of new housing on State-owned land to facilitate the smaller builder and encourage competition.

Social and affordable housing: Ten per cent of the completed units in all large-scale housing developments should be provided at nil cost to the State and a further 10 per cent provided at cost. This would deflate land prices and recognise the benefit the State is...

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