Heart Beat: 'Twas brillig and the slithy toves, Did gyre and gimble in the wabe: All mimsy were the borogoves, And the mome raths outgrabe.'
It strikes me that I have a serious problem. Well, at least one. I tend to believe what I read in the papers. Unfortunately, what is reported in the papers emanating from politicians and concerning the health services is often as difficult to understand as the above verse from Lewis Carroll. Maybe I have wronged many people in my criticism of what passes as our service, maybe the service is just fine and any little problems will soon be fixed? I might quote our Taoiseach: "In the five or six hospitals where there is a problem, we will continue to work with the Irish Nurses Organisation and the hospital management. The Health Service Executive is working daily on this issue to try to overcome the difficulties in the four or five hospitals that continue to have a problem." Wow, that's impressive; he managed to lop off one problematic hospital in just one paragraph. If he had spoken for just a little longer, he could have solved the whole lot.
Sorry Taoiseach, that simply won't wash. People are not blind and deaf. It is not four, five or six hospitals that have problems. It is nearly every acute hospital in the State. I am glad that you are all talking to the INO about solving some of the problems, and I must admit that not paying them the paltry pay rise due to them was a master stroke. It is sure to concentrate their attention and ensure their co-operation in whatever daft scheme one of your well-paid advisers will dream up next. While I am glad you are talking to the nurses, it strikes me as a little bit odd that you are not talking to the doctors also. Maybe you should, and could I deferentially suggest, that you try listening also. The Lord in His wisdom provided most of us with one mouth and two ears. He appears, however, to have provided some members of your Cabinet with several mouths and no ears.
On a more positive note, I read that you had admonished TDs for poor attendance in the Dáil. It didn't seem to work too well, but as one TD explained, Punchestown was on. I am glad the priorities are right. What an inspiration to those lazy doctors and nurses.
Since I am complaining again, I might as well get some more off my chest. General surgeons in the UK have accused the government of betraying the NHS by spending billions on contracting out standard and routine operations to the private sector leaving public hospitals under-funded and under-equipped to handle difficult and long-term cases. Nothing new for us here, we have the National Treatment Purchase Fund. In an interview in the Irish Medical Times with NTPF chief executive Pat O'Byrne, it is stated that "the idea of spending money on private healthcare while public hospitals close their beds has appalled some, it is difficult to argue with the results achieved since 2002".
Yes Mr O'Byrne, it has appalled some, dare I say many. These private hospitals mushroom without proper planning and proper safeguards for the patients, and draw their staff and their expertise from those expensively trained in the public sector. They make no contribution to such training and their raison d'etre is to make money for somebody.
At present, they shun long-stay and difficult problems and provide no all round emergency cover. Many cannot hope to survive other than through public work acquired from the NTPF or similar organisation.
There are a million other problems with the NTPF. It is a facile, ill thought-out solution to an extremely complex problem. This problem requires urgent comprehensive debate now before irretrievable damage is done to our once proud hospital system. What is happening now is reprehensible. By all means, have private hospitals but they must provide a full service and contribute to the cost of training staff. There is only one way to do this - make all patients, and thus all hospitals, private and in competition. This must be planned to allow for centres of expertise and must realistically be fashioned by need and not by geography or politics.
At the end of the article it states that the NTPF exists as a result of a Progressive Democrat policy idea. This is not attributed to Mr O'Byrne but it suggests that it would be "a shame" if the fund were the victim of a change of Government. I do not believe so. I feel that the next Government, of whatever composition, must produce a credible sustainable model to serve four million people, a model that is dependent on clinical need.
This can only be done by involving those who deliver the service. I gather from this paper today that the Minister may warn about dissent in the service. My oh my, perhaps she would be better employed pondering the causes of such dissent. For those working in this service, those who overstate the problems, those who don't wash their hands, those who refuse to compromise patient care, those who continue to highlight our shoddy patched-up service, I fear more trouble is coming down the line.
'Beware the Jabberwock, my son!
The jaws that bite, the claws that catch!
Beware the Jubjub bird and shun
The frumious Bandersnatch!'
Dr Maurice Neligan is a cardiac surgeon