'It's not about patients and how we treat them'

HEART BEAT: The talk is of cuts and diminution of services; not about the health of the Irish people, writes MAURICE NELIGAN…

HEART BEAT:The talk is of cuts and diminution of services; not about the health of the Irish people, writes MAURICE NELIGAN

EDMUND BURKE, Irishman and graduate of Trinity, distinguished British Parliamentarian and advocate of civil liberties, wrote while condemning the excesses of the French Revolutionaries, that they had shown themselves to be “the ablest architects of ruin that had hitherto existed in the world”. It’s as well he lived before our lot got going.

I think we could do with like minded forthright politicians. Among the causes Burke championed were free trade between Britain and Ireland and Catholic Emancipation.

At the time he was sitting as MP for Bristol. He took a principled stance on these matters, in the full knowledge that most of his constituents did not share his views. To accentuate this independence of constituency pressures, he also supported the cause of the American colonies. He did not deviate from what he held to be right and, in consequence, lost his seat at Westminster. He was a rare bird indeed, prepared to stand or fall on conviction.

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In the midst of our troubles here, some have advocated a National Government. They feel that the adversarial party model cannot get to grips with the problems that surround us and cannot impose the harsh solutions necessary. This is especially so since most of our electorate blame the present government for our plight.

They don’t trust them and despite efforts to tell us that they’ve had some form of Damascene conversion, such distrust is firmly entrenched. So let’s have a National Government and get the best minds that this country can produce to try to find a relatively safe pathway from the mire. This hasn’t been happening; we’ve endured waffle and procrastination.

“The fathers of the City,

They sat all night and day,

For every hour some horseman came

With tidings of dismay”

– (Macauley Horatius)

Our lot tell us they’ve been sitting, apart from the holidays of course, and the horsemen will have to wait until after Nama or Lisbon or the Budget or whatever else will keep the incumbents in power. Yes, we need a National Government and a sense of fairness and purpose.

There is one proviso about a National Government. We would need a general election first, to let the people decide the proportions of such a serious legislature. We need it soon; time is not on our side.

Into the maelstrom of disasters swirling all around us, the bold Prof Drumm stepped fearlessly again to tell us the HSE might have to reduce staff by up to 6,000, unless other ways could be found to effect savings mandated by the recently-awakened Department of Finance.

Maybe it escaped his notice that the main reason the old health board structures were abolished was to reduce staff and promote efficiency.

That is why it was accepted by so many as the way to go. That first tentative step forward was quashed by a crass and purely political decision by a former taoiseach, that in such reorganisation, nobody would lose their jobs. That’s what happened. The consequences are with us still.

Prof Drumm now tells us that front-line services like hip replacements and home care packages will have to be cut unless the HSE is allowed to continue with its slash and burn approach to the public system, which it whimsically describes as “reconfiguration”.

This word in HSE-speak means closing hospitals and reducing our stock of acute beds, already among the lowest in EC and OECD countries. It does not mean providing any alternative services elsewhere, let alone better ones.

We are told that we don’t need so many hospitals and beds, and that much of what they do could be equally well done in the community setting. We’re told that 120 primary care teams are in place and that the number will rise to 500 by year’s end. I have talked to GPs throughout the country over the past few months and the nicest word used to describe both of these assertions was “fanciful”.

Reading Prof Drumm’s reported comments was depressing. He has been head of the HSE since 2005 and this Government has been in office since 1997. The situation in Ireland’s health service is as bad as I and colleagues in medicine, nursing and paramedical disciplines can remember in our professional lives. We’ve been through the bulls**t expansionist phase, the grandiose planning and the squandering of money. Now the talk is of cuts and diminution of services. It’s not about patients and how we treat them.

The final straw, and I have to think there is a mistake here somewhere, is that in a note to the Joint Oireachtas Health Committee about revised estimates for the executive’s budget vote, the HSE has set aside €370.7 million for costs associated with the planning, construction and equipping of higher education facilities in respect of pre-registration nursing degree programmes.

Madness in great ones must not unwatched go

(Shakespeare Hamlet)


Maurice Neligan is a cardiac surgeon