Heart Beat: Through the Christmas in one piece and facing into a new year. This was a Christmas blighted for thousands by natural disaster. The world response of goodness and compassion makes one wonder why we cannot look out for our fellow men throughout the years, and not only when disaster strikes. I know this sounds Utopian but it is ironic that it requires catastrophe to bring out the best in humanity.
Meanwhile, for everyone else life goes on as usual. I await the New Year with interest, but with less optimism than earlier, regarding the future of our health service. I had not intended to write about this today, but I feel compelled to do so yet again, by the consideration of some of the pronouncements from official levels over the season of goodwill.
The noises we have all heard before. We need action now, but there is precious little of that in evidence. Waiting for improvements in the health service is rather like watching the grass grow. In fact, the simile is rather unfair to the grass, as it actually does grow. The service at best stagnates and, at a credible worst, actually regresses.
The old players remain in the game, and apparently guarantees have now been given to the unions that nobody will be discommoded.
Where now is all the fine talk of rationalisation and the concentration of expertise? We might have fewer health boards but apparently the numbers of administrators will remain the same. Where are the savings here? Do the patients count at all?
All we hear about is the re-negotiation of the consultant contract, as if this will suddenly solve everything. This, in fact, is the archetypal red herring. If the beds are not in the system, the doctors and nurses can do nothing. The yet again promised addition of 700-1,000 more consultants will merely lead to the same number of frustrated professionals being added to the payroll, still unable to perform their work.
If the beds and the staff were there, there would be no waiting lists. This is a simple fact and is the core of the problem.
The strangely independent National Treatment Purchase Fund would lose its raison d'etre. It is, far from being a great success, the evidence of total failure of our present system. We are now expected to believe that these people taking control of waiting lists will somehow make the situation better.
To the cynical it might appear as an effort to conceal the true position. I am among the cynics. I am deeply unhappy about what this fund means to the continuity of patient care and to the establishment of responsibility for the individual patient.
Doubtless in true Irish fashion this will ultimately be played out in the courts and, as usual, nobody will be responsible.
The system is collapsing, and privatising bits of it simply will not work. The problem must be addressed in whole and not in part. The omens are not good, the talk is still there but the action is not. The hundred days are over, so let's hear less and see more.
Enough complaining for one day.
The rain is decreasing and the wind is lessening and there is a vague possibility that one might be able to stand upright outside. There is just a possibility that I and my fellow lunatics in Dooks Golf Club might be able to venture forth in the not too distant future. Let nobody underestimate golf as an exercise, particularly in conditions like these.
Last Sunday our captains had their joint drive-in, and this was followed by a 9-hole competition in conditions so bad that even the birds were not abroad. Gale force winds, rain and hail were incessant and, believe me, a cardiac stress test paled into insignificance compared to this challenge.
However, I must admit that the mental capacity of those participating could well be called into question. As a medic I know of course that addiction is very hard to treat, especially when the addicts as a group display little insight. The phone is ringing. "Shall we chance it?" All fellow addicts will recognise the necessity of a fix. There ought to be treatment centres for us.
Next week I am going to write about the start of my life as a doctor, my intern year in Dublin's Mater Hospital. I was standing at the bottom of another ladder and preparing to climb. It was arguably the most exciting era of modern medicine, and I thank God that I was there.
It has started raining again. I guess I'll just have to bite my nails.
Maurice Neligan is a cardiac surgeon