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Last Updated: Tuesday, 22 May 2007, 05:39 GMT 06:39 UK
Public services stir Irish passions
In the run-up to the Irish general election on Thursday the BBC News website is looking at some key issues affecting modern Ireland. Here, Stephen Fottrell investigates the state of Ireland's public services.

Early on this election campaign was overshadowed by the personal finances of Prime Minister Bertie Ahern. But now public services are dominating the debate in the final stretch.

A striking nurse outside St Vincent's Hospital in Dublin
Nurses have staged a series of strikes ahead of the election
House prices and rising taxes are among the other all-important election issues, but the sharpest criticisms have come from voters who complain that, for all its new prosperity, Ireland's public services do not come up to scratch.

Healthcare is consistently the number one issue among Irish voters and could play a massive part in deciding who wins the closest election in Ireland for years.

Enda Kenny, leader of opposition party Fine Gael, has said the election should be a referendum on the government's handling of the health service.

In the lead-up to the general election the issue has become a political minefield.

High-profile industrial action by nurses and proposed action by consultants, as well as a major health scare in water supplies in the west of Ireland have added to the government's headache over the issue.

Public v private

Confusion seems to be the main gripe among patients and voters, as for many people the line between public and private healthcare provision is unclear and patients do not seem to know what level of care they are entitled to once they enter the hospital door.

Dr Patrick Plunkett
Doctors and staff are not being involved in the process
Consultant Dr Patrick Plunkett

Consultants are at the heart of the debate and their relationship with the government is deteriorating by the day.

To say there is disquiet among health service staff would be the understatement of the campaign.

Dr Patrick Plunkett, a senior consultant at St James Hospital in Dublin, says there is a lack of accountability on the part of the government that is "Stalinist in its approach".

"Doctors and staff are not being involved in the process," he says.

"With new consultant contracts being imposed before the election, the entire process is being politicised. Irish taxpayers and patients will pay the cost of that.

"People are being forced into private healthcare. Fifty per cent of people in Ireland already have some form of private health coverage. But with more people being forced into private care, it will raise the costs of health insurance. It's all a short-sighted political approach."

Traffic jam on Irish road
Long traffic jams have become part of the Irish landscape
The government maintains that its proposals are in the interests of patients and points out that there has been sustained investment in funding for the health service in recent years.

The recent opening of a new 75m-euro (51m) maternity hospital in Cork is one example of where that money has been invested.

But many health service professionals complain there has not been enough investment to sustain the number of patients needing care in a country that has seen huge population growth.

Many local doctors, for example, complain of a lack of funding. "There has been minimal state investment in general practice and primary care," says GP Martin Daley, from Ballygar, County Galway.

"The government reneged on its promise. In 2001 it promised 1.3bn euro for primary care, but only 300m euro of that has been spent."

'Not enough space'

Tadhg Kearney
Infrastructure is catching up with the population, says Tadhg Kearney
Another major issue for voters is transport. With more and more cars appearing on Ireland's roads, huge traffic jams are now part of many motorists' daily commute.

"There is not enough space on the roads for all the cars, which have doubled in numbers in the last 15 years," says Tadhg Kearney of the Irish Transport Users' Council.

"The country's economy and population has grown, but its infrastructure is only catching up."

"There has been no proper investment in the roads by the government, well maybe in Dublin, but not in the rest of the country," says Galway motorist Derek Fallon.

"I do a lot of driving as part of my job and you should see the state of some of the roads I travel on."

Road deaths are a major problem throughout Ireland. The country has the highest percentage of deaths among young people on its roads in the EU.

The government says further investment will continue to improve Ireland's roads over the next five years, and there is already a visible improvement on many of the country's main routes, particularly around the cities.

Notable transport successes on the government's part include a new tram system in Dublin and upgraded trains between the main urban routes.

Rural 'discrimination'

Declan Kelleher
Principal Declan Kelleher complains of a lack of funding in schools
Education is also a key issue, particularly among voters living in rural areas.

Parents, principals and teachers complain that schools are not receiving enough investment to accommodate increasing numbers of students.

"There's no excuse in a thriving economy like ours that we have such a lack of investment in schools," says Declan Kelleher, principal of Corrafin primary school in County Clare.

"We want to build an extension onto our school, but we've received no government funding for it. We have to go out into the community and raise the funds ourselves. As a rural school we're being discriminated against."

The government claims, however, that it has trebled investment in schools and put 10,000 extra teachers in place.

It also claims to have overseen the largest school building programme in the history of the state since it took office 10 years ago.

Ireland's divided voters will decide on Thursday whether these achievements have been enough to save this government.

Bertie Ahern and opponents on the campaign trail

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