Madam, - Prof Tom O'Dowd is right to invite "fair-minded and committed" consultants to articulate a vision of medicine that is distinct from their usual mercenary self-interest (June 18th). The latter, he implies, is a widespread perception of consultants' primary concern, created by the pronouncements of groups such as the Irish Hospital Consultants' Association and embellished by detractors such as Maev-Ann Wren and Vincent Browne.
Sadly, recent history offers little encouragement to independent consultants to add to the debate about the future of healthcare. Even though Irish consultants overcome extraordinary obstacles to mount their "pedestals", even though the overwhelming majority of them undertake the work of three or more of their Continental counterparts, and even though they labour in pitifully under-resourced institutions, the shameless avarice of a significant number of "fat cats" among them and the unforgivable hubris of others achieve the greater impact. Disastrously, this makes the criticisms of Ms Wren and others seem self-evident.
The real difficulty for healthcare planners, however, is the years of drudgery that causes so much consultant despondency ("too long suffering can make a stone of the heart"). The understandably bleak choice for many consultants, then, is between burned-out unkindness or a tunnel-visioned dedication to income. It would be nice to think that decent, hard-working consultants might make a case for better harnessing their talents through better human and material resourcing (I think they call this "efficiency"). But the fact is that health economists and correspondents are now strategically and politically in the ascendant and consultants are "the enemy".
Thus, instead of recognising the obvious (that to get more from our consultants we need far more of them) and rather than carefully examining the consequences in Britain of crushing all public sector opposition (especially consultants), we are set to ape the Blairite approach to healthcare: "floggings will continue until morale improves".
But then, that's what you'd expect a consultant to say, isn't it? - Yours, etc.,
L.C. LUKE,
Consultant in Accident
and Emergency Medicine,
Cork University Hospital,
Wilton,
Cork.
Madam, - According to your Editorial of June 19th, 95 per cent of voters think the Government has broken pre-election health promises. It makes me wonder: who are the 5 per cent with their heads in the sand? - Yours, etc.,
OLAN McGOWAN,
Ballinteer,
Dublin 16.