Madam, – There is a sweet irony running through your recent correspondence from Dr Mel Bates (January 19th). The biblical admonition about motes and planks cannot be far away. At the best of times, medical politics cannot be separated from doctors’ income.
While the recent VHI increases are partially a testament to a rampant medical test industry, it would be fair to say that many patients would be seriously uncomfortable with the tenor of the debate that Dr Bates is stimulating. While it is obviously not his intention to denigrate his colleagues, he does make a valid point about the greed of many professionals.
In my own professional arena, community pharmacy faces many commercial threats, most of which have been well reported. What has not been made clear is the rapacious attitude of some of Dr Bates’s colleagues towards my profession. The development of some primary care centres has been characterised by an extraordinary attempt to capitalise on the commercial prescribing power of groups of clinicians.
Indeed, the long-running saga of the Killarney primary care centre has been marked by an apparent unhealthy dependence of the whole project on the income to be generated from a pharmacy.
The parallels with Dr Bates’s nightmare scenario are uncanny. Cherry-picking clinics or pharmacies are all faces of a common problem. In both situations the public end up on the losing end.
I welcome the call for a debate on the future of healthcare policy, although I fear that it is already much too late. The shelves are groaning under the weight of all the reports that have been prepared. What is missing is a vision where patient needs are central. Perhaps the minister-in-waiting will put the needs of the patient before the professional. In an era of unique events, another milestone could be achieved. – Yours, etc,