Tony Holohan criticises desire for simplistic solutions during Covid pandemic

Former chief medical officer Dr Tony Holohan has criticised the proliferation of “simple solutions” to complex challenges during the Covid-19 pandemic.

No plan could have predicted what happened over the pandemic, and no solutions were to be found through the decision-making processes that were in place at the start of it, he said.

“In the media and elsewhere, there was a desire to oversimplify, to ignore complexity and to rush to simple answers to complicated and complex questions. Again and again through the pandemic there were many, many simple solutions proposed.”

“We would all have loved to find the silver bullet which would allow us to return to how things were, avoiding the health and wider impacts that came from the illness itself and the consequences, both planned and unplanned, of the measures put in place to limit its impact. But the reality was far more complex,” he told an RCSI conference on medical professionalism on Friday.

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An official inquiry into Ireland’s handling of the pandemic is expected to begin later this year.

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Dr Holohan said society needs to see health and wellbeing as essential resources for economic and social productivity, personal fulfilment and happiness rather than relying on a narrow monetary definition of what constitutes success.

He criticised “unbridled economic forces and the devastation they may wreak” through gross domestic product-based policies.

“The narrow focus on GDP fails to value the wellbeing of individuals and societies. It measures only economic output and not the quality of our lives. It does not consider the distribution of wealth, environmental impact or social inequality.”

“The emphasis on economic growth and GDP can lead policymakers to prioritise short-term gains over long-term, sustainable wellbeing. This is harming our environment and exacerbating social inequality.”

Spending on health should be seen “not as a cost to our economy, but as an investment in health and investment in people,” he said. “The economy exists to serve our wellbeing as human beings and not the other way around.”

The former CMO also criticised the adversarial approach adopted when things go wrong in medicine for contributing to “a culture of blame and fear”.

“When something goes wrong, doctors may fear the consequences of what they might say in apology or explanation. Sometimes that can lead to them responding defensively.”

“It can drive patients and practitioners on to opposite sides where trust and confidence break down. One effect is that healthcare providers may become more risk averse, which results in defensive medicine with increased healthcare costs and potential harms to patients who may be subjected to unnecessary procedures and tests.”

“Another potential effect of the adversarial system is that it may discourage healthcare providers from admitting mistake or errors for fear of negative consequences.”

Dr Holohan declined to comment on the recent report on his botched secondment to a professorship in Trinity College Dublin, saying he had issued a statement at the time it was published.