HEART BEAT:Affluence failed to improve our service - daily stories of neglect flood in
JOHN GARDNER, who founded the US lobby, Common Force, and who was Secretary for Health, Education and Welfare in the Washington administration in the mid-1960s, wrote of prevailing times in the wealthiest country on earth.
"We get richer and richer in filthier and filthier communities until we reach a final stage of affluent misery - a crocus on a garbage heap."
It seemed a fitting description of our health system. It's great if you get there. That's the crocus. The trouble is with access. That's the garbage heap. Not alone has affluence failed to improve our service but, arguably, it has blunted the susceptibilities of those unwilling to heed, let alone contemplate, this danse macabre of suffering and inadequacy that daily unfolds.
Daily stories of neglect and substandard conditions flood in, stories that - in any democracy worthy of the name - would demand the resignation of those responsible. Here, we all seem impotent in the face of stubborn persistence in policies (if indeed they are such) that have clearly failed. It takes a big person to say: "I/we got it wrong, let's start again." We don't seem to have big people.
From all over the country come pleas for help for our sick and disadvantaged, both mentally and physically. Such calls were initially shrugged off as rumour-mongering and false alarm engendered by "vested interests". Such interests were doctors, nurses, paramedics of all sorts, dentists and pharmacists - in short, just about everybody working in the system.
The Minister and Prof Drumm, on their high horses, would take on and vanquish these dragons of vested interest and then, miraculously, all would be well. Simple, no? Webs of obfuscation, half-truths and deceits were woven into their crusading banner under the mantra "we're not to blame".
Sadly, this was believed to a certain degree and - for one reason or another - the Government was restored to power. I do not believe for one moment that, in view of the electoral eclipse of the Progressive Democrats, the public intended the health portfolio to remain in the hands of a party with 1 per cent electoral support. I do believe that the policies pursued by this party in the sector are responsible for the situation we find ourselves in now.
Of late the tune has changed. No longer do we hear of malcontents sabotaging the White Knights; we hear the bald admission that "we have no money". Contradictions abound, as usual.
We hear of the site selection of the new hospital to serve the stricken northeast. Progress at last you would say. Not exactly: up pops the Minister for Foreign Affairs, telling all regional interests in the area to calm down and not get excited about the proposed location.
"Why so?" ask you.
"Because the cupboard is bare," sez he. "There isn't a red cent available to build it."
You may well ask, then, about the plans for centres of excellence, cancer strategies - grandiose plans for solving all our problems. You may well ask, but you're not going to get any answers, at least any that are believable.
It's not only in the big things that the pathological penny-pinching plays. "No, you can't have your home help" and, crueller still, "we can't afford your respite care. You'll just have to soldier on because you must understand we have a statutory obligation to remain within budget. Don't forget we have to pay our bloated bureaucracy and provide bonuses to the top brass as well.
"So forget about your old mother and don't be bothering us - and don't bother whining to the media. Get it into your thick heads that this is not about care and compassion. This is about money."
Sadly, the bull doesn't stop. A thousand new consultants to stare at the wall like their fellows currently in post, a consultant-provided service, whatever that means, the new consultant contract that is supposedly to solve everything. It's all talk, not to be taken seriously by the cognoscenti.
There is no meaningful contact between the Minister for Trolleys and her henchpersons in the HSE, and the increasingly demoralised frontliners in the caring professions. Their workloads are steadily rising and their numbers are being whittled down by the policy of job freezing - no locums, no replacement, no overtime, and so on.
The approach of these arrogant people seems to be, in the words attributed to Lyndon Johnson, "grab them by the balls and the hearts and minds will follow".
It didn't work in Vietnam either.
Maurice Neligan is a cardiac surgeon