HEARTBEAT/Maurice Neligan: First and foremost I wish to apologise. I had not intended to write about medico- political issues for some time as they were simply wrecking my head. However, along came RTÉ's Prime Time with its stark revelations and this was followed by a peculiarly somnolent Questions and Answers.
Nobody on the latter programme appeared to be too exercised about what they had just witnessed. The one honourable exception was the lady from Patients Together who tore up a copy of the Patients Charter in front of the cameras. She need not have gone as far back as the Patients Charter. She should have brought a copy of Quality and Fairness, a health system for you. This is a summary of the health strategy and is of more recent vintage. In its modestly called Vision it promises "A health system that is there when you need it, that is fair, and that you can trust."
Recognise that anybody? These sentiments appeared to be conspicuously missing from the situation once again highlighted by this Prime Time programme. Indeed, this wonderful piece of fiction also promised an extra 3,000 beds of which 650 were to be in place by the end of 2002!
The programme was trenchant and hard hitting, but it let those responsible off lightly. It did not portray the mileu of these unfortunate patients requiring admission. It did not capture the atmosphere of fear, exhaustion, aggression, permeating patients and staff in these conditions, and the leavening of drunks and addicts adding to the problems.
What was the response from Tweedledum, the Minister for Trolleys, and Tweedledee, the HSE chief executive? They assured us that they are both honest folk doing their best in most difficult circumstances. They are both deeply committed and they simply want to make things better. They assured us that action is imminent and a solution is just around the corner. They just have to sort out the arrogant consultants, the lazy nurses, the bolshie unionised paramedics and anybody else they can think of.
They tell us with a straight face that the number of patients on trolleys is declining, while piously intoning that of course even one such is unacceptable. I suppose it is pointless to tell them that trolleys are a bit like oysters, they disappear when there is no 'r' in the month. The real medical and nursing experts point this out and also the inevitability of recrudescence of the problem come next winter.
I listened despondently to Prof Drumm in a soft interview with Pat Kenny on these subjects. "I'm only in the door a little while and given time to tear down the old system and create the Promised Land; I will get it right" seems to be a fair synopsis of what he said. I wish he could acknowledge that we need more beds. Call them what you like - admission lounges, acute medical units, step-down facilities, long-stay beds, whatever - they are simply beds. The good professor came across as somewhat of a visionary and that always bothers me.
Men said he saw strange visions
Which none beside might see
And that strange sounds were in his ears
Which none might hear but he.
(Macauley, the Battle of Lake Regillus)
I have a piece of gratuitous advice professor, bearing in mind Lord Chesterfield's aphorism: "advice is seldom welcome; and those who want it the most always like it the least".
Well, like it or not, here it is: Go talk to the real workers and not to those who were ever present throughout the developing crisis and who now seem to think that by changing their job descriptions that they can change their mindset.
Please refrain from declaiming rubbish like "consultant provided service". You know how it works throughout the world. "Consultants should work in team"; you know they do when such is relevant. "CHDs should be appointed to teams rather than to individual consultants." You know they are in most instances. Some €50,000 a year overtime on average for NCHDs. Shame on you as you know this to be untrue and has aroused intense anger among this hard working group who are learning their trade while working to provide care. It is counter productive to blame the carers for the present situation. You should go and listen to them and then formulate rational policy, hospital by hospital.
A point to be made to all you folk who may read this. You are all entitled to be public patients and to use the services that you have paid for. That 52 per cent of you have chosen not to swallow the canard of our "caring service" is simply a tribute to your common sense and perception. Yet when most ill, you may find that the private service that you thought you had secured, is unavailable. Where do you finish up? In A&E just like everybody else.
Let us have no more spin and defence of the indefensible. We need immediate action before an upcoming election. The Taoiseach dismissed the NHS consultant who commented on the Third World scenes he had witnessed in the Prime Time documentary. In effect, he told him to mind his own back yard. How could any such consultant, indeed any caring individual, have said less? It is ironic indeed since in Government, you are all happy to quote foreign "experts" including those from the NHS when it suits you. Taoiseach, you are presiding over an uncaring, undignified shambles and although you are a man of peace, perhaps a few heads are required? No, I will not hold my breath.
Dr Maurice Neligan is a cardiac surgeon.