# Is Ireland a low taxation economy?



## Geoffreyod (17 Dec 2003)

The government claims it is!
I'm not sure it is.

Anyone know of anywhere online where you can quickly compare rates of taxation in the Eurozone.
I'm not concerned about Scandinavia or Switzerland where they have decided to do their own thing.

I'm not looking for info. about taxation for businesses but for the individual.


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## Contango10 (17 Dec 2003)

*overall burden of tax*

First of all, remember that people pay all taxes, sure who else is there in the country to pay them?  Companies pay corporation tax, but really it is the shareholders, customers and/or workers of the company who bear this burden.

Sweden, tax = approx 55% of national income.  This is the highest in the world.  Note that Ireland used to have such high taxation.

EU average = approx 45% of national income.

Britain = approx 40%.

Ireland = under 35%, maybe close to 30% of national income

Ireland has the lowest burden of tax in the EU.  Income tax and especially PRSI are low here, though indirect taxes are higher.  Low property taxes.

Contango10


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## Geoffreyod (18 Dec 2003)

*Tax values*

How can Britain be 40% when highest rate of income tax in Britain is 40%.

Property taxes- I remember watching a program on BBC2 where two guys were trying to sell their house for in excess of £500000(note not Euro) but nobody would offer more than that because that was the point at which stamp duty increased from 3% to 4%.
Don't we hit higher rates of stamp duty at lower price levels and don't we hit 42% income tax earlier than most other countries.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: Tax values*

Are we not talking of the net impact of all unavoidable direct taxation and related deductions - e.g. in Ireland this would be tax and PRSI/health levy, in Britain it would be tax and social insurance and so on? It seems to be very difficult to find any summary surveys dealing specifically with the net impact of direct personal taxes on take home pay in different countries but the surveys that cover both personal and corporate tax certainly seem to identify Ireland as a "low tax" country.


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## daltonr (18 Dec 2003)

*Re: overall burden of tax*

Contango,

do your figures include the total tax burden, i.e. indirect taxes e.g. VAT, Bin charges, fuel levies etc. Or are they just direct (income) tax.

It's be useful to know the income the government generates in total per capita in each country.  Then we could accurately compare the kind of service they provide.

-Rd


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## Geoffreyod (18 Dec 2003)

*take home pay*

Without complicating matters, I like to know what take home pay is after tax for an average Joe on an average(??) salary of €32,000 without taking into account additional tax credits.

This would ignore that your €, once you've earned it, buys less here than in practically any other country in Europe.


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## Contango10 (18 Dec 2003)

*Re: overall burden of tax*

Geoffreyod and Daltonr,

my figures, which are approx, refer to the sum of all taxes, i.e.

direct (= income plus corporation)
indirect (= VAT plus duties)
capital taxes
property taxes

I can't swear that they are just central govt, or if they are central plus local govt.  Social Insurance (PRSI) is very likely included in these figures.

I could get tons of more precise data, e.g. as published by the ESRI, etc.  I might, depends on the mood I'm in.

As to daltonr's point about per capita tax revenue, I have never seen that sort of data.

As to the earlier point: how can the UK govt collect 40% of national income in tax, while the top income tax rate is just 40%.

Simple:  they collect loads of other taxes, like fuel duty, VAT, National Insurance, Capital taxes.

Here's an example: say I earn 36k, pay 18% of my income in direct tax.  I actually pay more, when VAT and excise duty is added (difficult to calculate).  So overall, the Irish Govt take 30% of total income, though just 18% of my gross wage.

Contango10


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## Contango10 (18 Dec 2003)

*hit 42% tax rate too early*

Geoffreyod,

excellent point.

One of the big problems in the Irish tax system is not the overall burden of tax, which is low, but the fact that *average people on average wages reach the 42% tax rate too early*.

At 28k, for a single person.  The gross average industrial wage is now over 28k.

That is the killer.

*Solution: more rates*.  UK has 3, USA has 6 rates.

i.e. 20%, then 30%, then 40%, then maybe 50%.  You would only hit the 40% at, say, 40k.


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## Geoffreyod (18 Dec 2003)

*low rate tax country for who?*

So does that mean that when FF and PD blow their own trumpet about this being a low tax economy and ask us for our votes that we should say "perhaps, it is but what's that got to do with anything".
Does "low tax economy" need to be qualified as actually a "very low tax economy for business and relatively high tax economy if you work for a living which when aggregated is a low tax economy".
Seems to me that low tax economy is a governmental  marketing type term which when examined means what it means but people psychologically read other more favourable meanings into it.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: take home pay*



> Without complicating matters, I like to know what take home pay is after tax for an average Joe on an average(??) salary of €32,000 without taking into account additional tax credits.



€25,624.08 p.a. (or €2,135.34 p.m.) after tax and PRSI according to Karl Grabe's tax calculator - i.e. the direct personal tax (and PRSI/health levy) take is 20%.


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## Contango10 (18 Dec 2003)

*average vs. marginal*

Well, what I was getting it is that even though my average income tax = 18%, I pay 42% at the margin on extra income.

So overall taxes are low.  But if you get a promotion, do overtime, extra income, etc., you are hit at 42% plus PRSI.

C10


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## Alex (18 Dec 2003)

*Re: take home pay*



> the direct personal tax (and PRSI/health levy) take is 20%



there's a similar (ish) calculator on taxcentral.co.uk which shows that the equivalent UK tax (and national insurance) take on £22,500 (c. €32,000) is about 25% - the NI amount is the real killer at almost 9% with very few reliefs or allowances.  Ireland's direct taxes are very low IMHO and could do with being upped substantially to invest in some decent services (provided we could trust the politicians to do the right thing ......... but I think we've seen this debate somewhere else on AAM already)


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: take home pay*



> Well, what I was getting it is that even though my average income tax = 18%, I pay 42% at the margin on extra income.



Contango10 - I was simply replying directly to Geoffreyod's specific query just in case there's any confusion.


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## Geoffreyod (18 Dec 2003)

*concur with Alex's figures*

Used Prudential UK taxable income calculator and Karl Grabe's calculator

about 20% here at 32000.
about 25% in UK.


Put salary in at 40000(£28120) and
both UK and Ireland had risen to about 26%.


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## Contango10 (18 Dec 2003)

*bit slow*

0,

I was actually replying to geoffreyod, but as I am a bit slow at typing, your reply was in quicker, so it appeared I was replying to you.

Of course, that will probably happen again now.

Contango10


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: bit slow*

No problem!


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## heinbloed (18 Dec 2003)

*low tax*

It depends how you look at it.Tax dodging is some sort of culture here.They have the lowest control rate on bookkeeping according to the department of finance.No where in the EU you see children selling smuggled cigarettes,unlike Dublin.Diesel laundering is not worth the legal trouble somewhere else in the EU.Untagged (unaccounted!)cattle is UNTHINKABLE for
continental farmers,their colleges would set the shed alight. E.t.c....


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## daltonr (18 Dec 2003)

*Re: low tax*

OK, here's a comparison between UK and Ireland.
As best as I can figure it.

Single Male, Gross Salary €40,000,
No pension or other reliefs.

UK
Gross             £40,000
Allowances      £4615
Monthly Tax    £702
Monthly PRSI   £248

Monthly Take Home       £3333 - £702 - £248 = £2383


Ireland
Gross              €40,000
Credits            €2560
Monthly Tax     €674
Monthly PRSI    €166

Monthly Take Home       €3333 - 674 - 166 = €2493


So we are better off to the tune of €110.
Council tax in the UK puts us further in the lead.  I don't know the rates, but I checked with one person who's paying roughly €1200.

However they get their bins collected for that   , and a big chuck of the money goes to paying for local police.  I don't know how their crime rates compare.  

From there onwards however the UK quickly overtakes us,

They pay much lower VRT and road tax, but higher tax on fuel.
(tax on use not ownership)

Top rate of VAT is only 17.5% compared with 21% here.
Lower rate is 5% compared with (12.5% or 13.5% here anyone know?)

BIK Rate is 20%,  ours is 30%

Stamp duty in the UK on a 100K house is 1% or £1000
on a 1 million house it's 4%.

that's the tax situation, I think on balance it's probably too close to call.  In terms of direct taxes, income and local taxes, we probably shade it, but you'd need to compare the service we get.

In terms of other taxes VAT, Stamp Duties, etc.  The UK kicks our ass.  And let's be honest, these are the regressive taxes that hit lower earners harder.

The real difference however is in the cost of day to day items in shops.  Some of this is down to lower VAT but not all.  Even though the exchange rate makes a £7 STG purchase cost €10, in all liklihood that's still cheaper than you'll get it for over here.  Argos is 30% cheaper in the UK than Ireland.

That £7 purchase could well cost you €13 or €14 in Ireland.

Car insurance is much cheaper (but they still think it's expensive).  I got a quote more then 50% cheaper in the UK than Ireland.

You can live in the equivalent of Brighton which in distance terms is Carlow or Kilkenny and commute into the capital by train.  Trains leave every hour or so, and they leave early enough to get to work.

Public transport in the city and even intercity is such that you don't need a car at all.  In fact you are better off without one.

what the hell am I still doing here!?!?!

I'm off!

-Rd


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: low tax*

And another thing...

Even though the UK has a CGT top rate of 40% their system is arguably more beneficial to most small share holders with CGT charged as follows:

- First £7,900 of any gain charged at 0% (personal annual allowance)
- Next £1,960 charged at 10%
- Next £28,540 charged at 20%
- Balance charged at 40%

In Ireland it's

- First €1,270 charged at 0%
- Balance charged at 20%


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## rainyday (18 Dec 2003)

*Re: low tax*

Faraway hills are greener...


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: low tax*

Surveys do indeed support the claim that UK grass contains more chlorophyll than its Irish equivalent. On the other hand Irish residents do have the advantage of 40 shades to choose from. You pays your money...


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## daltonr (18 Dec 2003)

*Re: low tax*



> Faraway hills are greener...



They certainly seem greener whenever I visit.  

I'll say this though.  For all we complain about our TD's, at least we don't have to listen to the Guffaws and Bawling that goes on in Westminster.

Give me the Babbling Bertie, Earnest Enda, and Perplexed Pat any day.

-Rd


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Dec 2003)

*Re: low tax*



> For all we complain about our TD's, at least we don't have to listen to the Guffaws and Bawling that goes on in Westminster.



You obviously didn't tune into the Budget "debate" earlier in the month so. Unbelievable. And Oireachtas Report is the best comedy that RTE have made since, er, Quicksilver...


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## YakYak (20 Dec 2003)

*Taxes*

Ya just don't get it!!  It's useless just comparing just income tax rates today... or that we get onto the higher rate quicker than others etc.etc.etc.

The big difference between here and other countries is the social insurance payments (PRSI etc.).. Most other EU countries, and Germany and Scandinavian countries in particular have huge social insurance payments on top of their income tax.  And the result:  They've nice roads and everything works there!!  When you add everything up, we have one of the lowest combined taxation/social insurance rates in the EU, if not the lowest.  Hard to believe... but go abroad and you'll understand.  

But what does that mean.. are we fooling ourselves?  I firmly believe you get what you pay for, so if we're not paying high social insurance etc. then who's going to pay for the hospitals/roads?  Hmmmmmmmmm....... well.... the magic guy in the sky with a big wallet?   Hardly.   Clearly, we are going to have to pay for these in some way at some time.  Charlie has to get the money some way.   At the end of the day if you do believe you get what you pay for, and everyone in the EU wants the same standard of living, then we'll all end up paying the same...whether that's direct, indirect, CGT, VAT, PRSI... etc. etc. etc.   Stop getting hung up on individual rates, and some belief that everyone else is doing better than you.  Far away hills.... they ain't green!


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## daltonr (22 Dec 2003)

*Re: Taxes*

YakYak

The problem isn't that the government don't get enough money from the tax payer.  The problem is what happens with the money when they get it.

We are not getting value for money right now, and the worst thing you can do with someone who's squandering money is give them more.

-Rd


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## househunter1 (23 Dec 2003)

*Re: Taxes*



> firmly believe you get what you pay for, so if we're not paying high social insurance etc. then who's going to pay for the hospitals/roads?



I disagree. The job done on the roads here is substandard. With a little bit of planning and accountability you can make less money go further. The way our infrastructure is administered, they'd probably do twice as much damage with twice as much money. What really did it for me was to see the abysmal job done on resurfacing the road near my house. Total waste of money. 

As regards tax levels it appears Charlie is in favour of catching as many people as possible in the tax net, and thereby maximising revenue. He tries to figure out ways of doing this so that people will not evade tax. The government will take *as much as they can get* and use sophisticated 'risk analysis' methods to achieve this aim. I read an interview last year where he admitted this. Fair play to him, he's a cute hoor............but as regards the administration of our infrastructure........ its time for revolution!


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## Marz (26 Dec 2003)

*Another Thing*

A single person here on a low income (e.g. €15,000) will be expected to pay for GP visits, medicines, a certain amount if hospital stay is required, and for dental treatment).

Whereas someone in the UK who earns £10,000 (which is about the same amount) will not have to pay for GP consultations, medicines, hospital stay, dental treatment (if they use an NHS dentist), or bin collection.

In fact, up in Northern Ireland one can get all the above plus there is no water charges.  I know someone who lives in Newry and their property tax is about £270 for the year.  Plus goods are cheaper, presumably because there's a lower VAT rate.


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## Marie (28 Dec 2003)

Looking from the UK side of the pond, taxation in the RoI appears more complex (but perhaps I'm thick?)  But surely the difficulty with making league-tables of tax rates and quality of life across EU countries is this; if a small country like Ireland wishes to have roads, health and education and environmental services, of the same standard as, for example, Germany or UK, then that would be a HIGHER CHARGE PER CAPITA of the population? No?


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (28 Dec 2003)

> Looking from the UK side of the pond, taxation in the RoI appears more complex (but perhaps I'm thick?)



As far as direct personal taxation goes the move from tax free allowances to tax credits a few years back simplified the calculation of income tax. PRSI/health levy calculations are still a little tricky. I think the UK use tax credits as well but I've no idea how National Insurance deductions are calculated.


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## Sean (28 Dec 2003)

No not necessarily.  If the population is lower then by definition there are lower numbers in education, in health care system, on the roads etc.  So tax does not necessarily have to be higher per capita of the population than a country with a higher population.

Also, if we're talking about health care, it is a disgrace that gp consultations and medicines are not paid for directly out of the public purse.  Yes, there is a medical card system but according to the Oasis site one can only be obtained for a person under 66 years old if their Gross income is under €151 per week (about €7176 per annum, gross).

If taxes have to go up in order to pay for a health care system where anyone can go to a gp free at the point of use and obtain free medicines (at the point of use), then if taxes need to rise then in my opinion that is what should happen.  I would rather pay more tax if I thought it would prevent the taxation of sick persons on low income, which is effectively what we presently do.

Incidentally according to the World Health Organisation, Portugal has (as far as I can recall) about the 7th best health care system in the world.  Ireland is about 19th.

As far as I'm aware Ireland is more wealthy than Portugal.  So, perhaps tax does not need to rise in order to produce a much better public health system.

But whatever the reason for the current state of our public health system it is something for which we should hang our heads in shame.  IMHO we should be moving towards a system where most (if not all) public health care is delivered free at the point of use to all Irish citizens.

Concerning the question "Is Ireland a low taxation economy", it is probably a higher tax economy for those on low or middle incomes (when services which have to be paid for privately are taken into account).


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## darag (6 Jan 2004)

just to pick up on one of your statements sean, i don't 
see what's "disgraceful" about people who can well afford 
it paying for services like visits to the gp, etc. i earn a 
reasonable income and can afford to pay for gp visits, 
occasional dentist visits, proscriptions, etc.  i don't see how 
this is a "disgrace"?  i pay a lot of taxes but i don't see 
why i should be entitled to gobble up government social 
spending on things i can well afford to pay for myself.  there 
are people far more deserving of social welfare. spending it 
on them might go some way towards tackling the real social 
problems in this country instead of making swathes of 
services "free" to everyone. less than 20% of the population 
live in real poverty and suffer social deprivation.  i'd rather 
this sector were targetted with government spending and 
social services. society as a whole benefits much more if a 
child from a socially deprived background is given 35 quid 
worth of school books or an hour of one-on-one teaching than 
if someone on 50k a year or a wealthy pensioner gets a free 
visit to the gp.


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## daltonr (6 Jan 2004)

Darag,

I suppose the point is that given that we do pay for GP's Dentists etc.  You'd expect that we would have a far more equatable society.  We seem to have the worst of both worlds where you have to be in almost abject poverty to qualify for a medical card.

I don't think I should have my GP bill covered either, but in return for paying it I'd like to see far less people in the tax Net (i.e. nobody on the minimum wage should pay income tax) and far more people eligible for medical cards etc.

-Rd


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## Sean (10 Jan 2004)

*Health Care*

If public health was available free at the point of use, then you would still be paying for it Darag; through your taxes.  If someone is on a good income then they pay a higher amount of tax which would constantly cover public health care at all times, and for the length of time you have the good income.  You would not be paying more only when you as an individual become sick.

For example, if someone earns €7500 (Gross), we would say this was a very low income.  However if they become sick they have to pay for gp consultations, medicines, carriage by ambulance, hospital stay etc.  This would amount to a huge percentage of their take-home pay.  If they have ongoing medical problems then they have to constantly pay for this year-on-year.  Someone on €7500 is expected to pay for all their healthcare just as someone would who earns €80,000.  That’s what I think is disgraceful, and I cannot see how anyone could see this as being fair.

If all public health care is paid for out of direct taxation, and free at the point of use, then people (especially on low income) would not be constantly concerned about being hit with a huge bill (as a percentage of their income) if they become sick.  If it's free at the point of use they know exactly where they stand.

So people on a good income would still be paying their share of the public health care bill.  They would be paying through the tax system, and not only when they as an individual become sick


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## darag (10 Jan 2004)

*Re: Health Care*

you don't need to be in "abject" poverty to get a medical
card.  about 40% of the population are covered by the 
medical card system and receive completely free medical 
care. sean, your 7500 a year example is silly because such a 
person would certainly get free medical care in this country 
including free gp visits and proscriptions.

the government has finite spending and so it must make
decisions about where the money goes.  like i said i'd prefer
welfare money was spent on improving the suffering of the
disadvantaged and genuine hardship cases in our society 
instead of being wasted on ideologically driven desires to 
make stuff "universally free".

i prefer the system in this country than the uk's nhs even 
though the execution of the health service here leaves a lot 
to be desired.  those who can afford it pay themselves by
buying insurance and government money is reserved to pay 
for the needy who can't.  i don't see anything at all repugnant
or disgraceful about this and i dunno why people get 
indignant about this system.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (10 Jan 2004)

*Re: Health Care*



> those who can afford it pay themselves by
> buying insurance and government money is reserved to pay
> for the needy who can't.



Everybody is entitled to free hospital care (bar some relatively small and capped per-visit and accommodation charges):  . Most people buy insurance (and I believe that many people overinsure because they don't understand that higher cost plans often simply offer "better" accommodation - only if it is available and it's often not - rather than a higher level of patient care etc.) because they don't want to take the risk of ending up on waiting lists if they need a major operation done all of the sudden. The National Treatment Purchase Fund is supposed to be sorting out the waiting lists but I'm not familiar with how that's progressing.


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## rainyday (10 Jan 2004)

*Re: Health Care*



> the government has finite spending and so it must make decisions about where the money goes. like i said i'd prefer welfare money was spent on improving the suffering of the disadvantaged and genuine hardship cases in our society
> instead of being wasted on ideologically driven desires to
> make stuff "universally free".



Hi Darag - The problem with this approach is that it inevitably creates poverty traps, e.g. people who are not encouraged to move from unemployment taking up relatively low-paid employment because they could lose the medical card facility for their family. 

NB I'm not commenting on the rights/wrongs of this approach - just pointing out one impact that may not be immediately obvious.


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## darag (11 Jan 2004)

*Re: Health Care*

i agree O; many people don't realise this and assume if they
don't have bupa or vhi and they require hospital care it will
cost them a fortune.  the most i've ever heard anyone having
to pay was about 20 quid a day for their stay in hospital and 
this isn't means tested or anything.  i don't bother with 
health insurance myself anymore for this reason. 

i agree rainyday but i don't think this is a fundamental 
problem with a means (or income) tested welfare system.  
there are lots of bad boundaries in our welfare system but 
this is because the government has never tried to make 
welfare benefits "progressive" in the same way the tax 
system is.  a  progressive welfare system would be much 
more equitable and not just for healthcare.

if our tax system worked like our welfare system, then we 
would pay tax along the lines of a fixed 8 grand tax bill
if you earn over 16 k a year. you can see how this would
disadvantage those earning between 16 and 24 k.  the
non-progressive nature of our welfare system creates 
similar traps.


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## househunter1 (12 Jan 2004)

*Re: Health Care*

Interesting
What do you reccommend for a healthy person in their late twenties and early thirties. Should they get health insurance, or is it just a waste of money under present circumstances? I


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (12 Jan 2004)

*Re: Health Care*

Having always had private health insurance I still find it hard to break the habit of having it even though I am a late 30 something in excellent health and no significant risk factors. However in the past few years I have moved to BUPA (cheaper than VHI and better service in my experience) and down to their most basic plan (pretty similar medical cover to more expensive plans but "only" covers public and some semi-private (?) accommodation expenses which suits me fine). As I mentioned above private health insurance with semi-private and private accommodation expenses cover doesn't guarantee that accommodation - it is always subject to availability and often limited in supply! As ever with insurance it all depends on the individual. I can certainly understand darag going without health insurance...


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## Sean (25 Jan 2004)

*Health Care*

According to the website I previously mentioned the Eu7500 figure I mentioned is not silly.  The criteria is stated on the website.  

I’m sure many people on good income here in Ireland do wish to retain the current system.  They can live in the delusion that they are paying for their own health care (and therefore not detracting from public health). Yes they are paying for their own health care, though someone on a good income is, almost by definition in good health (obviously not always).  Also, as they’re in a higher tax band, they will get a higher tax refund so they are actually paying less for their health care!  

Those on low income are more likely to suffer from worse health, and they obtain less tax back on their health care!  So, they have lower income, they spend more on their health care, they obtain less money back from the State.  I can see why some wish to retain such a system.  It means they can shirk their responsibilities to those less fortunate.

By the way, the system I mentioned would be free only at the point of use.  Obviously it is not “free”.  It’s simply another way of looking at something.  Income tax would have to cover this health care.  The upside is that there would be no gp consultation fees, no medicine fees, no hospital stay fees, no ambulance fees, no dental fees (as with NHS dentists) etc.  That might not sound great to someone on good income as of course they most likely do not go to the gp often.  They’re on good income, therefore they’re probably in good health.  Though for someone on lower income it would be greatly beneficial. I can see where people on good income who are in favour of the current system are coming from.  Obviously it benefits them.

Public health care in this country  has to be looked at in a different way.  With the current system, even with all the extremely hard work and dedication of nurses and doctors and other health care professionals, public health care in this country is in a dreadful state.  According the the World Health Care Organisation, Irish public health care is ranked lower than UK public health care.

IMO, we should be sending health professionals to Portugal to learn about how a small country can provide a world class health system for it’s citizens


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## Marie (27 Jan 2004)

*paying for health care*

This morning on the radio interviewer asked hospital consultant what doctors' feelings were on accusation they were 'breaking contract' by using public health service facilities to treat their private patients.  Consultant's response was that the statistics were deceptive as privately-treated patients 'spent only a short time in hospital'......implicit in the dialogue was that (a) there was no difficulty transferring to rehab nursing care/residential care for privately-treated patients and (b) that privately-treated - aka 'wealthier' - patients were in better general health which reduced their use of the service. 

This is flawed logic!  An elderly friend (self-professed socialist!) tired of waiting on NHS waiting-list (UK) did some internet research and enquiry and had  his back-operation done in Malta by a world-renowned surgeon.  It was cheaper than NHS private treatment (even counting in his flight and hotel accommodation).  This man had been in extreme pain for two years and his gait was so badly affected it was having a knock-on-effect on other joints (knees etc).

However I have another friend - a Maltese living in the UK - who expressed his disgust at 'health tourism' pointing out that those now flocking to India for cataract removal procedures or in this case, Malta, or to Budapest actually create longer waiting-lists and more deprived conditions for the indigenous populations of the 'health tourism'.  

Health tourism is a logical extension of the two-tier private/public system insofar as the investment of public funds (for the equipment in operating theatres, the infrastructure, bureaucracy etc, especially the expensive state-funded education of doctors, nurses and professions allied to medicine) are used for 'private' healthcare;  so the state subsidy is skewed to benefit the more educated, more informed, wealthier strata of society.  THIS is the invidiousness of the system!  

Any suggestions on how requisite health care could be accessible to all according to need not wealth/influence?


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## darag (2 Feb 2004)

*Re: Health Care*

sean, like i said 40% of the population have completely
free health care as they are covered by the medical card
system.  i don't see what benefit there is to spending welfare
money on the other 60%.  it it nonsense to suggest that
the poor would benefit from universally free health care.
at best they would be no worse off than they are at the 
moment. how would the relatively poor who are on medical
cards benefit from your suggestion?

that the health care system is badly run in this country is 
a given. but i fail to see how making gp visits, etc. free for 
relatively well off people will improve the health service.


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## Sean (7 Feb 2004)

*.*

The percentage of the population which has a medical card is made up of those of 70 years old and over, children, the unemployed, those unable to work for medical reasons etc.

The criteria I previously stated for obtaining a medical card for anyone else is valid.  So, for anyone who works they effectively do have to be in poverty to obtain one.

BTW, I don't want anyone thinking I'm some raving socialist, as I am a business owner.  I simply think it is unfair that those on low income pay such a large proportion of their income on health as opposed to those of us who are better off, and pay a much lower percentage.

So maybe not universally free, I have by no means examined this in any great detail.  But, IMHO the criteria for obtaining a medical card for those who work should be raised well in excess of where it is now.  I don't think it would be unreasonable for anyone earning €30,000 or less to obtain one.


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## temptedd (7 Feb 2004)

*Re: Health Care*

Marie,
The vast majority of people who pay for VHI are employed and pay taxes. They pay for the public health care system. Then they pay extra for private health care. There is a tax incentive to do so, as the public health system receives an additional income from their insurer when these people use hospital services. The state would be considerably worse off if these individuals did not "pay twice" for their health care.

tedd


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## rainyday (7 Feb 2004)

*Re: .*

Hi Tedd - Isn't this a bit of an over-simplification?

Semi-private/private patients aren't generally paying twice *for the same service*. They may well be getting the same medical service (just ignoring the issue of who delivers the service for the moment, i.e. consultant or registrar or ....), but semi-private/private patients are paying extra for the extra space/privacy/crockery/food that comes with the semi-private or private room.

If there was a mass exit from VHI/BUPA and those people were all suddenly dependant on the public health service, then sure, the system would definitely be overloaded and the state would be worse off.

But if there was a mass exit from VHI/BUPA and those people all moved out to private hosipitals (just ignoring the capacity issue for the moment), then surely that state would be better off, and public patients would get treated more quickly?


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## Tommy (8 Feb 2004)

*Re: Health Care*

Semi-private/private patients are indeed paying twice for the same thing every time they occupy a public bed in a hospital - if you visit a "private" patient in hospital, there is a good chance they will be in a public ward, often by their own choice.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (9 Feb 2004)

*Re: .*

In many cases people who are entitled to semi-private or private ACCOMMODATION (the medical care will be exactly the same) under their private health insurance cover or whatever will end up on the public wards anyway because such entitlements are subject to limited availability. There is often no choice involved at all. People who pay for private health insurance because they want semi-private/private accommodation should bear this in mind. I suppose the other main reason that people take out private health insurance is to avoid waiting lists for elective procedures.


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## daltonr (16 Feb 2004)

*Re: .*

A person on the minimum wage in Ireland must Pay BOTH Tax and their healthcare costs.

The fact that minimum wage workers are in the tax net is incredible.  The fact that even then they are not entitled to a medical card is criminal.

Talking about what percntage of the population are entitled is meaningless.  There are people in this country who literally cannot afford to get sick.  Worse, they are paying through tax for the health care of others who are better off than them.

I'm not a raving socialist either.  Some things are just wrong regardless of where you sit in the political spectrum, and no statistics make them right.

-Rd


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## Marie (17 Feb 2004)

*public funding of private healthcare*

This does not add up!  The cost of bureaucratic infrastructure, roads and transportation system, general medical/specialist medical, dental, nurse and professions-allied-to-medicine training, land, buildings, equipment, consumables and utilities of "the healthcare system" (or simply, "the hospital") are all borne by "the state"/"the" taxpayer (it doesn't matter for the moment how much the eponymous taxpayer contributes).

The "private patient", like the "public patient", taps into all this when she has her procedure.  The VHI/BUPA/private scheme insurance does not buy medical care/treatment/swish accommodation!  What it buys is privileged ACCESS!

If the terms of the debate were made clearer decisions on optimal healthcare delivery would be easier.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Feb 2004)

*Re: .*



> The fact that minimum wage workers are in the tax net is incredible. The fact that even then they are not entitled to a medical card is criminal.



So where do you draw the line then? 

A single minimum wage earner (52 weeks x 40 hours x €7.00 per hour = €14,560 p.a.) pays a maximum of €352 in tax and €318.32 in class A PRSI for the year by the way.


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## darag (18 Feb 2004)

*Re: public funding of private healthcare*

daltonr, numbers and statistics are what separates 
opinions from fact.  i disagree that they are meaningless.
i doubt you could produce figures to back up your gloomy 
picture of hoards of minimum wage earners dying from lack 
of health care because they can't afford it.

0 has gotten in ahead of me somewhat but i think the 
calculated salary is a little high.  on average, there are about
220 working days in the year so a minimum wage worker
will earn about 12,300.  i've put this salary figure in the
online tax calculator and the tax liability for this salary
is zero.  so such a person is not "paying for the health care of 
others who are better off than them".

secondly your claim that such people cannot afford to get 
sick doesn't really stand up either.  non-elective hospital care
in the country is free and the balance of prescription costs
over a lowish threshold (70 euro a month?) are also paid for.
even if you have to visit a gp 10 times in a year, this would
cost around 3% of the minimum wage salary.  finally, in 
extreme cases, the health boards can and do step in with
financial support.


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## Geoffreyod (18 Feb 2004)

*VAT and PRSI*

Is VAT and PRSI completely seperate?
Does VAT find it's way into Public secotor salaries for Health workers.

On Des Bishop work experience he was complaining that even on just above minimum wage he had already started to pay tax.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Feb 2004)

*Re: public funding of private healthcare*



> 0 has gotten in ahead of me somewhat but i think the
> calculated salary is a little high. on average, there are about
> 220 working days in the year so a minimum wage worker



I wasn't sure about how to calculate the annualised min. wage so used the 52 weeks x 40 hours x €7 approach. Perhaps the 220 days x 8 hours x €7 approach is more accurate?



> Is VAT and PRSI completely seperate?



What do you mean? VAT is charged on certain (most) goods and services - not most staple/essential foodstuffs though. PRSI/health levy are deducted from income. They are completely separate in this respect. Maybe you mean something else?



> On Des Bishop work experience he was complaining that even on just above minimum wage he had already started to pay tax.



I wonder what his "minimum wage" figure was? Did he mention it? I can't imagine that he was paying much tax.


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## Geoffreyod (18 Feb 2004)

*minimum wage*

in superquinn he was on 7.45.  AFAIK in Abrakebabra he was on 6.35.
On programme he showed his pay slip to the camera and tax was deducted.

Does anyone know if government's VAT take is kept away from financing the Health service?


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (18 Feb 2004)

*Re: public funding of private healthcare*



> In superquinn he was on 7.45. AFAIK in Abrakebabra he was on 6.35.



Presumably the Abrakebabra programme was made before the new minimum wage of €7.00 per hour was introduced in early 2004?



> On programme he showed his pay slip to the camera and tax was deducted.



If he was hopping from job to job for the purposes of the programme (did he REALLY do these jobs or was it a set-up?) then perhaps he was also on emergency tax at some point?

The bottom line is that a minimum wage earner will pay little or no tax. Whether or not a minimum wage earner should pay ANY tax or when people should enter the tax net is obviously a valid point of debate and discussion.


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## Protocol (18 Feb 2004)

*VAT*

GeoffreyOD,

all govt revenues are put into one big pot, out of which expenditures are made.

Taxes are not earmarked for particular expenditures, bar one or two exceptions.

e.g. motor tax goes to Local Authorities

Protocol


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## darag (19 Feb 2004)

*Re: public funding of private healthcare*



> Does anyone know if government's VAT take is kept away from financing the Health service?


it is yeah geofrey. a friend of mine works in the civil
service in the department responsible for keeping vat away 
from health spending.  they use a purple indelible die and a 
rubber stamp to mark notes and cheques raised from vat 
with "not to be spent on the health service".


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## Sean (19 Feb 2004)

*Health Care*

I don’t think anyone would claim there are hoards of minimum wage earners dying from lack of health care in Ireland because they can’t afford it.  It is nice for us to talk here about such things here in an almost “hypothetical” fashion; though how many of us here earn Euro 12,000?  Also, not all low paid workers will obtain minimum wage based on a forty hour week.  Some/many will not have 40hr contracts.

My major concerns with the present health system are that those on low income have to pay a higher proportion of their income on health care.  

For someone on low income I do not think Euro70 per month paid for medications is a low amount.  If someone pays the maximum of Euro70 per month (as some do) for medications for a year this is Euro840 + their gp expenses.  For someone who requires frequent gp visits this could amount to Euro 500.  Then maybe add in any other tests/in-patient stay/ambulance charge.  So it’s quite possible for such a person to end up paying Euro 1500 in a year.  Around 12.5% of their gross income.  Someone who earns Euro 70,000 does not pay 12.5% (Euro8750).  In fact they probably don’t even pay the same amount as the low-paid person (Euro 1500), as they are most likely in good health.

Is this “fair”?  I suppose it’s a matter of opinion.

Yes, in extreme cases the health boards can help with financial support. Again, I have major reservations with such a system.  I do not think it is right that any Irish citizen is put in the position where they effectively have to go begging to a health board for help with medical expenses.  It is simple for us to suggest such options, though we are not the ones who will be going to the health boards for help.

This is why, in my opinion, it is preferable for health to be free at the point of use for the majority.  Even if someone on low income did have to pay a relatively low amount of their income on their income on health care, there is also another moral argument.  E.g. Two people earn Euro 12,000.  One pays Euro 500 in a year because of illness, the other pays nothing as they were not ill.  Is it right that a fellow citizen (especially low-paid) has had to pay Euro 500 because they were ill?  Illness is not a consumer choice; it’s not something someone chooses to become.

Also, in my opinion the more a population has to worry about paying medical expenses (especially for those on low income), the more negative ramifications there are for other aspects of society.


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## True Blue (19 Feb 2004)

*Re: public funding of private healthcare*

The reasons why our health services is suffering is due to the wastage of resources and money because
of 

1. red tape
2. 'Consultant' fees
3. Over inflated wages
4. Time wasters.
5. Insurance liability

The health service being a public body will always be abused:- If everybody owns it, nobody owns it, therefore nobody cares.

The way forward for the health service is:

1. Cut down on red tape
2. Reduce consultant fees and over inflated wages - employ from abroad if possible
3. Send more people aboard to have operations
4. Fine time wasters
5. Bogus compo seekers when found out should be fined or even jailed for a week or two - and then billed for courts costs etc.
6. Privatise non-essential services.


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## Geoffreyod (19 Feb 2004)

*Darag, your last post was of absolutely no help.*

Sarcasm doesn't help to clarify anything and Protocol had already responded in a more helpful manner before.

In a country with high VAT rates going to support public services it is a valid question to ask if VAT paid by the poorest sections of society is used to prop up a health system that the wealthier sections may or may not get disproportionate advantage from.


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## daltonr (19 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*

All of the Des Bishop Shows were shot before the increase to €7.00.  AKAIK Superquinn just paid more than other employers.

Yes he appears to have actually done the work for a month in each place and he did show all the payslips, but didn't get into whether or not there was emergency tax.

He made it clear on a few occasions that he did not get paid for days he was sick, so he had the double expense of paying for the health care, and not getting paid in work.

He also exposed some questionable practices like telling people their job included free food, and then taking the cost of food out of their earnings anyway.  But if you're on the minimum wage I presume you don't really have much opportunity to challenge this kind of thing.

I don't know if he was entitled to get paid for sick days and holidays, I don't know if he was entitled to have his treatment and medication paid for, but he made it clear on more than one occasion that he was constantly being told by well off people that he was entitled to things that he just wasn't entitled to.

As for whether or not minimum wage workers can afford to get sick, well... if they can afford €70 per month for medication, plus whatever GP fees they have, then yes they can afford to get sick.  

O's right the debate should be about whether those on the minimum wage should be in the tax net at all.  I'd say no, but if they are then in return at the very least their GP costs and medication should be fully covered.

Can anyone confirm the following for me:  If I go to a GP I may be asked to pay up to €50 for the visit, My last vist was €45 for a 5 minute visit with no prescription.

What's the story if I go to A&E?  Is it cheaper?  Is it free?
Is this the reason why A&E is overflowing?

For the record, I earn a hell of a lot more than the minimum wage, but after my last visit to a GP, I'd need to be passed out cold and carried into a GP's office to get me there.
So I can't imagine how someone just scrapping by manages.

-Rd


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (19 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*



> I don't know if he was entitled to get paid for sick days and holidays, I don't know if he was entitled to have his treatment and medication paid for, but he made it clear on more than one occasion that he was constantly being told by well off people that he was entitled to things that he just wasn't entitled to.



I haven't seen the show at all but I guess his statutory rights would differ depending on whether he was a part time or a full time employee:

www.entemp.ie/erir/empl2.htm



> If I go to a GP I may be asked to pay up to €50 for the visit, My last vist was €45 for a 5 minute visit with no prescription.



Depends on your GP. Mine charged €35 last time I visited and nothing for follow up visits relating to the first.



> What's the story if I go to A&E? Is it cheaper? Is it free?
> Is this the reason why A&E is overflowing?



Presenting at A&E without referral costs €45 (with an in-patient/daycare charge of €45 per day subject to a maximum of €450 if applicable) in most cases:



As far as I know there is still a problem with people presenting at A&E with complaints which might merely warrant a visit to the local GP or health clinic.


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## daltonr (19 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*

Is there any difference in recovering the cost of A&R v's GP?

There must be some reason why people prefer to use the overcrowded A&E Dept's than simply call and make an appointment with a GP?

Is it the opening hours?  Does A&E have more recent magazines in the waiting area?

-Rd


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (19 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*



> Is there any difference in recovering the cost of A&R v's GP?



A&R - I know that rock bands can claim artist's exemption on their income but that's about it.   However, assuming that you mean A&E I don't really understand the question...


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## daltonr (20 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*

What I mean is, if it costs €45 to attend A&E and probably less than that to attend a GP (mine was €45 but I've heard that's on the high side),  then why are so many people choosing A&E over their GP?

Is there some advantage that I can't see?  Is there some way of claiming back some or all of the €45 paid to A&E that you can't do if you go to a GP?

Can anyone explain why A&E is so popular?

Having been in A&E once for a genuine emergency, I can't imagine why anyone would find it preferable to a GP.

Is it just that there are a lot of people who don't have a family GP and can't be bothered getting one?  Or is there a financial incentive?

-Rd


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## Protocol (20 Feb 2004)

*GPs vs. casualty*

Hmmm, well they don't you there and then in the A&E, they don't have a cash register, they send you a bill.

So less pressure to pay.

If you have a medical card, both are free.

I suppose the answer is that if you break a leg, the A&E are going to be much better prepared for accidents, etc., whereas the GP is better for non-emergencies.

Also, take what happened to me, dog bit me on Basin St., off Thomas Street. Not based in Dublin, so know no GPs. Meanwhile, I fear rabies, etc. Very handy that the largest hospital in the State is nearby, so in I go to St. James' hospital A&E.


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## darag (20 Feb 2004)

*Re: Darag, your last post was of absolutely no help.*

sorry geoffrey; are you telling me your question was
not rhetorical?  you asked it two or three times in a manner
which suggested you were bursting to to make some point or
other.  o.k. so i was in an irritable mood when i read your
questions, but sure enough, my sarcasm seems to have 
prompted you forego your usually coy nature and actually 
state your point regarding vat.  i dunno about you, but i'd 
prefer it if you just made whatever point it was you wanted 
to make instead of repeating vacuous questions.  it would 
save me the effort of coming up with sarcastic comments 
which takes a lot of effort i don't mind telling you.


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## <A HREF=http://pub145.ezboard.com/baskaboutmoney.s (20 Feb 2004)

*Re: GPs vs. casualty*

This is better than Footballers' Wives!


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## daltonr (20 Feb 2004)

*GP V's Casualty*

I'm not convinced that all the people clogging up A&E are tourists or visitors from other parts of the country.  And I don't believe that we have that many accidents and emergencies every day that ALL of the hospitals in Dublin should be overcrowded with 200 people on trolly's last week.  If we have that many accidents then we have bigger problem than the health service.

There is something other than resources behind all this.

* Is it drink related late night accidents?
* Is it a financial issue for people?
* Is it that people can't be bothered to get a family gp?
* Are we the most accident prone nation on earth?

Also has anyone noticed that complaints about the Hanley report seem to center on downgrading A&E services, while the ministers response always seem to focus on centralising major services like Cardiac and cancer care.

Isn't there a middle ground?  Centers of excellence for things like cardiac, cancer care etc, while maintaining and improving A&E services around the country to deal with patients immediately after an accident before moving them to a major hospital.

Comfort for people that treatment is available nearby, while getting all the benefits of multi-disciplinary centers of excellence.

As usual, I'm confused.

-Rd


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