Heart Beat: I am in a good mood because something nice happened to me. Apparently I and my colleagues were the best paid doctors in the world.
Not enough I might add to be in the Getty class, "if you can actually count your money, then you are not really a rich man", but we got more than other similar doctors around the world. I wouldn't have believed that from my travels and meetings with international brethren. I suppose they just put on a show to disguise their penury, rather like what they used refer to in the north of England as "red hat, no drawers".
Not alone for the doctors was there good news. Those nurses, who are always complaining and causing trouble, turn out to be the third best paid in the world. Aren't we all an ungrateful shower? I suppose this explains the paradox as to why so many nurses leave the profession early. Why continue working so hard when you have made your pile?
Our health minister tells us it is so and who would disbelieve her? She tells us these figures come from the Organisation for Economic Co-operation and Development (OECD). How the OECD knows this, isn't quite clear.
I suppose it must be able to computate public and private systems, consulting room, secretarial expenses, cost of medical insurance, benefits in kind and cost of living generally. A sort of super PPARS in effect and probably just as accurate.
I missed the bit where she revealed how the OECD felt about health ministerial salaries and administrative salaries in the service.
However, the doctors of the Irish Medical Organisation and the Irish Hospital Consultants Association are in talks with Government about a new contract and they are well capable of representing themselves. In the Churchillian phrase "better jaw jaw than war war". It would be nice to see this being done in a calm business- like way with both sides prepared to listen.
The outcome is too important not to wish success on the talks and, like every such negotiation, everybody will not be completely satisfied. This is going to be long and arduous and best restricted initially to the protagonists.
It is no time for bluster or threat but for hard headed assessment as to the best way to improve the service. It is not as simple as the consultants only, also at issue in this context are facilities, above all the provision of more beds.
Meanwhile, I am about to return to the distant past when hospitals worked and we had patients rather than clients or customers or, even worse, consumers. I had parked my career during my tenure as a medical intern and was describing the duties involved therein.
The patients were admitted either by referral from a family doctor, anywhere in Ireland, from the outpatient clinics or through the A&E department. In the latter case what is now called triage would have postulated an initial diagnosis.
On arrival in the ward, the intern's job was to take a detailed case history and carry out a full physical examination. You also ordered the necessary pathology and radiology tests. Accordingly the patient, secure in a hospital bed, passed into the system. There was seldom the need for frenetic hurry. Consultant rounds came and went. Multiple conditions often required cross referral to other teams, surgical or medical. The futility of trying to categorise different patients and their conditions became apparent to us all very quickly.
Patients are different in every way and their individuality must be respected. They are not "a condition" who should be out of hospital in X days. In ignoring this we trivialise their humanity. Discharge came when the consultant deemed the patient well enough to go and there was somewhere secure to go. Yes, there were long-stay patients; there always will be.
Our problems stemmed from there being so many patients, and there not being enough hours in the day. The problems for the patients arose from the fact that treatment modalities were far more restricted than now and consequentially outcomes were often less favourable.
Administration from the good Sisters or the medical board hardly impinged on the lives of patients or doctors. I don't remember any ogres among the consultants although not all were placid and easy going. In short, the system worked well. It had enough beds to keep patients moving through, it was clean and well run. In our innocence we thought that hospital life would remain thus forever.
Vignettes remain with me to this day. Good Sister Stanislaus (known as long Stan, to distinguish her from short Stan who ruled the radiology department) heading for a patient in an oxygen tent, bearing a lighted blessed candle: "Jesus Sister are you trying to blow up the ward." The patient didn't survive, but taking 10 more along with him would have made the headlines.
Saturday morning, consultant to intern: "How is Mr X in St Patrick's ward?" Intern: "He is doing very well sir."
Consultant: "I had better look in on him." On approaching the ward a knot of gentlemen with black ties detached themselves from the wall.
"What happened to him, doctor? You told us he was going to be fine."
Intern stock dropped sharply with consultant and relatives. Later in residence: "How was I supposed to know he died last night, the bloody nurses or Mary Y (the covering intern) never told me."
Life or in this case death is never fair.
• Maurice Neligan is a cardiac surgeon.