The omens for the media in the general election campaign that has begun are not encouraging. Sam Smyth did an interview with Bertie Ahern for the Irish Independent on Saturday in which every question was facilitatory. Fianna Fáil and Sam's friends in the PDs have nothing to fear from that quarter, writes Vincent Browne.
Bertie appeared on Ryan Tubridy's television chat show on Saturday night. Again not a glove laid on the great man. In December, another RTÉ presenter gushed at Bertie: "The best year yet?" Michael McDowell has access-on-demand at RTÉ for soft-focus interviews (aside from Morning Ireland and the News at One). Mary Harney is regularly treated as someone who is unquestionably committed to rectifying the problems in the health service and is doing her best. And on and on it goes.
The media as a whole have accepted the parameters of the campaign. This is an election about economic management, about efficiency in the health service, about controlling crime, or rather a facet of criminality, and traffic. Anyone who thinks these issue are not what matters is "not in the real world". Other issues may matter but the issues on the "doorsteps" are the economy, health, crime and traffic.
And, of course, that is right. These are the issues on the "doorsteps" but does anyone in the media wonder why they are the issues on the "doorsteps"? They are the issues on the "doorsteps" because they are the issues in the media. As Michael McDowell acknowledged a few months ago in his RTÉ lecture, the private media determines the political agenda, not the politicians and, as far as he is concerned, it is the duty of RTÉ to follow suit. Certainly, as far as he is concerned, RTÉ has no entitlement to impose its own agenda, so in the absence of that entitlement and in the absence of any other agenda, it has no option but to follow the private media agenda.
A report was published five years ago now, Inequalities and Mortalities, by the Institute of Public Health which has got no political attention at all and almost no media attention - there was a segment of a Prime Time programme on it a few years ago but no follow-through there or elsewhere.
The report gave a shocking insight into the scale of inequalities in Irish society. I suspect that if the people on the "doorsteps" had an appreciation of what the report revealed, the issues raised in the report would be red-hot issues on the "doorsteps".
The report showed that for all the major fatal diseases, the incidence of premature death among the lower socio-economic groups was far higher than in the case of the higher socio-economic groups in both jurisdictions in Ireland.
One would have thought that the incidence of heart disease causing premature death would have been fairly uniform across the social spectrum. But in both jurisdictions, the mortality rate for the lowest occupational class for all heart diseases was 120 per cent higher than in the highest occupational class.
The premature mortality rate for strokes was 2½ times higher (150 per cent) for the lowest occupational class, compared with the highest occupational class. For cancer of the oesophagus, the premature mortality rate for the lowest occupational group was nearly 3½ times (250 per cent) that of the highest occupational group; for stomach cancers it was over twice (110 per cent); for pancreatic cancer, 60 per cent more.
Mortality rates for infectious and parasitic diseases for the lowest occupational class are nearly five times those of the highest occupational class. The mortality rate for mental and behavioural disorders was more than 4½ times; for alcohol abuse nearly four times; for drug abuse almost seven times; for pneumonia it was more than three times higher; for chronic lower respiratory disease it was nearly 4½ times; for diseases of the digestive system nearly three times; and for the genito-urinary system, nearly five times higher. The mortality rate for congenital malformations and chromosomal abnormalities for the lowest occupational group was nearly 10 times higher (930 per cent) than for the highest class.
The A&E crisis is not the most important issue in health, it is the massive disparities in mortality rates between those in the lower occupational classes as compared with those in the top occupational classes.
Of course, the causes for these huge disparities lie outside the healthcare system as well as within it. But isn't there something weird that such huge disparities in health welfare never get mentioned in debates over health? You would expect the Labour Party, for instance, to highlight this extraordinary evidence of inequality, but as far as I can see, it is entirely silent on it.
Just think forward to the debate between the two prospective leaders immediately prior to the election. One thing you can be assured of is that the issue of this massive unfairness will not feature. It will not feature in anything the candidates themselves offer and will not feature in any of the questions posed to them. Why? What is it that drives the issue of traffic to the top of the agenda or close to the top of the agenda in the coming election and nowhere on the agenda is this massive disparity in mortality rates between poor people and rich people? Ask Sam Smyth.