Madam, - In my general practitioner waiting-room one recent Monday morning I counted nine different nationalities - seven from outside Europe. Nearly 50 per cent of the medical school classes I teach are from outside Europe. I give advice and reassurance to patients on diseases I hope never to see. I offer travel vaccinations for countries I have never visited.
Modern medicine is heavily dependent on good, up-to-date advice from doctors who have the networks to get this advice and, equally important, the knowledge of the local scene. In my practice I regularly get advice from public health doctors on the latest diseases such as SARS and flesh-eating conditions from dirty needles. However, information about local cases of meningitis and measles and the need for prompt treatment and vaccination are equally valued. Most of us in clinical medicine do not have the bird's-eye view of the increasingly complex world of infection and are in need of prompt, trusted and local information.
We live in a world where cheap travel is the norm, where all but the poorest immigrant is able to return home for a family occasion, with the risk of bringing back infections normally associated with the other side of the world. My medical students who will graduate soon will bring family from all over the world to share their joy and of course expose their friends and colleagues to infections not normally found in Ireland.
Ireland is beginning to take an enlightened approach to a number of public health problems. Our tobacco consumption is falling, for instance, as part of good public health policy which includes joint approaches by the Departments of Finance and Health.
There is a danger, however, that the vintners' lobby will scuttle Mr Micheál Martin's ground-breaking ban on smoking in pubs and restaurants. To meet the arguments advanced by the vintners, and their friends in the tobacco industry, the Government needs good public health advice. It is easy to forget the chaos of drug misuse in our cities up to five years ago. Again, an enlightened public health approach together with treatment facilities has made many of our sink estates bearable for residents through the consequent reductions in drug-related crime.
The effects of our public health colleagues withdrawing their labour may well have disastrous consequences for a large number of people and for Government health strategies. As a patient and citizen I feel less safe and as a doctor I am less well informed and less useful to my own patients. - Yours, etc.,
Dr TOM O'DOWD,
Professor of General Practice,
Trinity College,
Dublin 2.