Sir, I wish to congratulate Sheila Wayman on her excellent article "There is such a backlog . . . " (Health + Family, February 16th), which shines some light on aspects of our faltering health service. No doubt there will be criticism of comments made from some predictable quarters but no complaints, I suspect, from the many victims of our collective failure.
I often apologise to patients for the failings in our health system but it’s time to stop defending a bad system and time to put things right and the first step towards improvement is to speak openly of root causes, if even in immodest and impolite tones.
It is time to expand a public debate on our healthcare system, a time to critically analyse the multiple deficits and inequalities many of which are institutionalised and normalised by group-think, by professional protectionism and cronyism and, of course, by the profit motive.
For instance, many junior hospital doctors face a bleak future. They are increasingly mass-produced in multiple medical schools, some privatised at enormous expense. They then face into a competitive process to gain higher specialist “training” over many years, only then to enter a competitive jobs market which cannot accommodate all of them.
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Ultimately many feel alienated and insecure. Some are offered precarious employment in the private sector but there is little security there. Many are in their late thirties, often married and mortgaged when the final opportunity for permanent secure employment passes. There is no going back. Some have simply given up medicine; many go away having embraced the medical student dream only to wake to a nightmare. Those who survive the process and become consultants often do so by exhibiting competitive traits not necessarily compatible with a supposedly empathetic and cooperative profession.
That is but one facet of a complex and potentially chaotic systems failure. There are more. They can, however, be rectified.
Our healthcare system is ill and is hurting patients and staff alike. It’s time for those who purport to be in charge and who are charged with that responsibility to stop defending the indefensible and reassuring us that all is well. The privatisation of medical education threatens its moral and ethical core. The mass-production of doctors irrespective of market needs is cynical and damaging.
The privatisation of public waiting lists is not a long-term solution to public waiting lists. The inequalities in the system are discriminatory and yet accepted by the majority year after year.
Those apologists for our discriminatory and unfair health care system are in a minority, and I for one wish to distance myself from them. – Yours, etc,
DAMIAN
McCORMACK,
Orthopaedic Surgeon,
Dublin 1.