Heart Beat:All sorts of clouds darken the medical horizon. It is hard even for the most optimistic to see progression into brighter times. That is apart from those political souls who see no problems at all, at least none that can't be fixed by them, if they are entrusted with office, writes Maurice Neligan
Hearing some of them talk, you could be forgiven for thinking, that apart from some minor problems, we have a world-class health service. Well we don't. We may have thrown money at it, but we haven't fixed it. What is to be done?
Well for starters, the people who actually provide the service have to be a part of this process. They know how the system works or rather, should work. There is a vast fund of expertise and goodwill available. It is not used; rather it is ignored or at worst decried.
As I write this the nurses are undertaking industrial action. Let me tell you something: nobody became a nurse for the money. It is a truly vocational calling. That does not give the rest of us the right to abuse their genuine goodwill.
Let me tell you something else; the nurses are the cement that holds the whole broken edifice together. Without them you have nothing. If they are dispirited and angry, it reflects through the service. If they are involved and appreciated, everybody benefits.
This is what I find inexplicable. The only way forward is by involvement and negotiation and everybody knows that. Why therefore bury a seed of bitterness for the future that will poison relations and make harmonious working relations in the service an unobtainable dream?
The nurses have done badly out of benchmarking and are unwilling to go that road again. Even the decision at the time, which led us to this impasse, was never explained. Thus they did not know how they came to be undervalued in comparison to other healthcare professionals, who carried in many cases less responsibility and some of whom actually had to report to them.
They have been willing to discuss rostering and new schedules and to enter into any discussions on productivity, however distasteful that word is in patient care context, but this was not to be. Once again in this service, confrontation became the order of the day.
It is the order of the day throughout this dysfunctional entity. The doctors, NCHDs, GPs and consultants are wrong; the nurses are wrong; the paramedics are wrong; the ambulance personnel are wrong. Everybody is wrong, except apparently those who don't know how to treat patients, and yet are paid vastly more than those who do.
This confrontational attitude has led, not as some would have us believe, to low morale throughout the service, but to bitter anger and resentment. It has led to this noble profession being forced to take actions which are anathema to them and their calling. So let us not blame them. Let us blame rather, the arrogant stupidity of those who forced them into this corner.
I read an article in the Irish Medical News on April 2nd. The author was Minister Brian Lenihan, Minister of State at the Department of Health and Children. It was entitled, "Health Services have improved vastly, but challenges remain". I rubbed my eyes and glanced again at the dateline, surely it must be April 1st?
But no, it was correct. I read on, wondering how anybody could make such a claim. Certainly I know of no health professional who would accept the highly selective view of the service peddled by the Minister. "We are now spending more than any other OECD country in our health services." That explains we are ranked 24th out of 25 countries in the group.
"Nobody can deny that we have used the fruits of our economic success to build up our health system".
Does the money already spent on the Mater/Temple Street project, some €55 million it is rumoured, come under that heading even though it is rendered obsolete by the decision to relocate the National Children's Hospital to that site? If this is so, how is it that such a vast sum could have been spent, without even a brick being laid on the site?
Also in this article, there is in my opinion, a classical example of confusion and misdirection. It concerns the vexed, and many would think misdirected policy of the co-located hospitals. I quote, "There are 2,500 beds in our public hospitals, which for many years have been ringfenced for private patients. In addition, many public beds are being used for private patients who are paying fees to consultants but otherwise enjoying all the publicly funded beds of the hospital free of charge.
"In other words, the taxpayer is subsidising private patients and private consultant practice at the expense of public patients!"
What is this nonsense? Does this Minister not know that everybody in this country is entitled to a bed in a public hospital? This was granted by the Minister's party before a general election, doubtless from the most altruistic of motives.
Is the Minister now telling us and them, that somehow they are not entitled to be there? Would he state this clearly and unequivocally before the next election? Is he suggesting that these, implied free-loaders, are not tax payers? No understanding here, certainly no silver lining in view, no fresh thinking, little hope; it is what we have come to expect.
• Maurice Neliganis a cardiac surgeon