A Chara, - Steven Young, consultant neurosurgeon at Beaumont Hospital (July 4th) outlines his dilemma very well. Faced with a situation where the standard of equipment at the main neurosurgical centre in the country is dropping to "Third World levels", he feels that, in the interests of his patients, he may have to accept that facilities will never improve in the public sector and that he should listen to the siren song of the "for profit" hospitals.
The other option would be to refuse to accept that change is impossible in the public sector and then do something about it.
Everybody knows about the trolley crisis, as a result of anecdotal horror stories, newspaper articles, television programmes and the vigorous INO campaign. It is a hot political issue. Everybody other than Mary Harney and Brendan Drumm knows that we need 3,000 more beds. Other gross deficiencies in our public system are not well known.
There have been protests from individuals and groups of consultants about problems within their own specialities - the Beaumont department of neurology, the "Tallaght Ten" who revealed that they share a mere 20 beds between them for orthopaedic surgery, the inadequate number of neurologists and rheumatologists has been highlighted. But these protests are quickly forgotten. There is little public awareness of the multiple problems of a severely dysfunctional system. Meanwhile, the sly introduction of the National Treatment Purchase Fund papers over the cracks, and is an important contribution to the profit margin of the private hospitals.
The lack of public awareness is a measure of the failure of the Irish Hospital Consultants Association and the Irish Medical Association. Steven Young is a member of the IHCA, a group of wealthy and powerful people. If each member contributed €1,000 - a voluntary contribution of seven private consultations - a fund could be created that could publicise the specific defects within the public hospital system that deprive patients of a first-class system. The INO and the various paramedical groups could be invited to participate.
Hopefully, a consensus would emerge. If not, the IHCA could go it alone. Proposed correction of the inadequacies would be accurately costed. The consensus would be presented to the political parties and their responses would be published.
The level of public debate would be transformed. Doctors would have to consider the common good as well as pursue their own sectional interests. They would have to convince the public that they had struck an equitable balance. Politicians would have to make a response.
Steven Young indicates that he would prefer to work in an equitable health system. He should reconsider his options. He and his colleagues could make the Department of Neurosurgery in Beaumont as hot a political issue as the unfortunate patients on the trolleys. But it will not happen without a widely supported, well-financed, sustained campaign. - Yours, etc,
PEADAR MAC MAGHNAIS, Bóthar Bhinn Éadair, Baile Átha Cliath 5.