Sir, - Dr Brian Larsen from Cheshire (January 10th) criticises my comments of January 9th. My letter was prompted by the impact of Kathy Sheridan's report on Tommie Gorman's illness on my non-medical friends. I was annoyed at the portrayal of Irish medicine and the inferences made. Clearly, from the independent reaction of Mr Gerry McEntee (January 8th) and Dr John Crown (Opinion January 9th), I was not alone.
Dr Larsen may not realise that while there are radiologists in Dublin trained to carry out certain therapeutic procedures, the absence of a critical mass of patients may make targeted referral of a small number the more appropriate treatment option.
Thus all treatments are available in Dublin but some clinicians may select other options for their patients.
Demoralisation among NHS consultants in the UK is at such a level that the majority wish to opt for early retirement. We don't need that sort of morale in Ireland. The whole country is familiar with the shortage of hospital beds. The "health crisis" will be eliminated only when bed occupancy rates in our large hospitals are at about 80 per cent at non-peak periods, irrespective of payment methods.
Dr Larsen obviously got the message that Irish consultants consider themselves worth more than £70,000 per year. It was Tommie Gorman's reported comments that elicited my reply.
Are consultants supposed to duck whenever money is mentioned? Well, I don't. If that is arrogance, then so be it. Dr Crown was merely more indirect and polite. - Yours, etc.,
Dr BILL TORMEY,
Department of
Chemical Pathology,
Beaumont Hospital,
Dublin 9.
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A chara, - I read with interest Dr John Crown's defence of Irish medical practice in relation to cancer treatment. It strikes me that there are two prongs to his defence, at complete odds with each other.
On the one prong, we have a high standard of excellently trained oncology specialists practising in Ireland, versed in the latest treatments relating to their specialities. This is my experience as a breast cancer patient.
On the other prong, we have a system so poorly funded and abysmally structured as to constantly compromise the standard of practice of said specialists. Again, this is my experience as a breast cancer patient.
I believe any constructive criticism must target our Government. We cannot expect our medical professionals to make silk purses out of sows' ears. It seems to me that it is all in a day's work for those employed in our medical system to strive for excellence within an undernourished environment.
I agree with Dr Crown that all cancer care should be concentrated in specialist centres with outreach facilities - highly equipped outreach facilities, I might add, so that when people are at their most vulnerable they are not travelling half-way round the country for the most basic treatments.
It pains me to read that such proposals have already been submitted by the professionals themselves, and rejected. Why? How more professional an assessment is required? We waste years claiming that a "team of experts" is "looking into" the structure of the medical system, when a perfectly rational "expert" proposal is sitting on the desk (or moulding in a filing cabinet!) right now.
I do not accept arguments grounded on funding. The Celtic Tiger has been and gone, with little or no positive impact on our medical system. Perhaps Mr Martin will accompany me on my next appointment to St Anthony's Breast Clinic - or does he have three or four hours to spare waiting in an uncomfortable "temporary" (for years temporary) prefab building, where files are kept in shopping trolleys and tea is served by a volunteer from the community?
I hereby authorise The Irish Times to proffer my telephone number to the Minister should he wish to take me up on this challenge - Yours, etc.,
'PAULA NOLAN,
North Strand,
Dublin 3.