A FAMILY AT WAR
If Simon Harris wants out of health after just 10 months in charge, Maurice Gueret asks what hope there is for Angola
Barely 15 years since RTE made the documentary Fine Gael: A Family At War, the party is squabbling over the car keys again. My granny’s sister was married to a barrister who was once spoken of as a potential leader of Fine Gael. He was elected TD for Wexford, and the party’s new coalition partners in 1948 thought he’d make a good compromise choice for Taoiseach, as he didn’t have any baggage from the civil war. History, assisted by a few backroom blueshirts, spared him from the ordeal. It was his parliamentary colleague, John A Costello, who became the ‘reluctant’ Taoiseach. Reluctant is not a word that really belongs in politics. Though, like Leo before him, young Simon, our health minister, could be reluctant to block that bed at Hawkins House for too long. Mr Harris is clever and quick to learn. It has taken him just 10 months to realise that health is not really Angola. It’s worse. Angola has long, sunny days, vast oil reserves and the promise of being one of the fastest-growing African economies. True, there are occasional landmines, but the real similarity is that access to prompt healthcare is dependent on whether you have money. No politician in Ireland or Angola has the dream to sort that one out.
It’s easy to spot fault lines on the seismic map of Irish healthcare. Implementing remedies is the hard bit. To my mind, there are too many parallel universes. There’s an ever-changing health department without bedside experience, jousting with a remote HSE that operates well away from patients on industrial estates and in closed hospitals. There’s a hospital-group system nobody knows anything about, and a dysfunctional interface between hospitals and the GP world outside. Then we have the tradeunion world, whose sole interest is the amount of money in the health pie that can be diverted to salaries, pensions and perks. There is the political world that craves publicity as it picks nits from the corpse of the public-health service, but hasn’t an iota of what it might do differently. There is a cherry-picking private sector that is not perfect, but at least rates patient experience, access and comfort in its thinking. It also pays attention to keeping family doctors in the loop and appraised of service developments, something unheard of in most public hospitals. There is a public mental-health service that keeps patients out of hospital, and a private mental-health service that prefers to keep them in. The last man into Health with a plan was Dr James Reilly. His instrumental delivery of a universal insurance scheme failed and was abandoned. We need to attempt delivery again. Using full anaesthesia and a scalpel if necessary.
There is an excellent society of medical writers based in the UK. They publish a regular journal where doctors and nurses who like to scribble can have their work published with ease. For a growing number of health-service personnel, humour is a reliable safety valve. Dr Chekhov would always say that while medicine was his lawful wife, literature was his mistress. The recent issue of the society’s organ had one gem about how hospital managers deal with complaints. Lady: “I wish to make a complaint. My husband was recently admitted to your hospital for surgery, but the operation has caused him severe loss of libido. Since his discharge, my husband has lost all desire for sexual relations.” The hospital manager replied, “Dear Madam. Thank you for your letter. We sympathise with your predicament. However we must point out that your husband was only admitted for cataract surgery. All our surgeon did was correct his eyesight.”
The actor John Hurt tip-toed quietly off stage in January. There were so many highprofile deaths last year that perhaps 2017 rings in a more measured reaction to the great inevitable. I liked John Hurt. His portrayal of the Elephant Man was probably his best-known film role, but his most memorable performance was as Dr Stephen Ward. The London osteopath was convicted in 1963 for living off immoral earnings, and later took his own life. The film was Scandal, and it covered the events of the Profumo spy affair that rocked an early swinging London. John Hurt came to mind recently as I read about new legislation to lower the drink-driving limits to zero. He once said that if you order just a single glass of wine with your meal in America, they consider you an alcoholic. Sounds like intolerance and prohibition are on their way here, too.
I was pleased that the Irish Cancer Society got a knuckle rap for their ‘I want to get cancer’ campaign. It doesn’t matter how much money they raised, or attention they gained. What matters is that a respected organisation founded to help patients shouldn’t risk upsetting those same patients by deliberately using insensitive slogans to grab attention. There are as many public-relations specialists working in health now as there are publichealth nurses. When too many birds sing at the dawn of day, none of the songs are heard. Raising the volume, squawking or tweeting all day and all night is not the answer.
Recent UK statistics hint that we are falling out of love with cosmetic surgery. Operations fell by a whopping 40pc in 2016 according to the British Association of Aesthetic Plastic Surgeons. Just 31,000 women and 2,500 men went under the knife last year. I was taught at a young age that the best way for a face like mine to improve its prospects was to bury it in books.
Dr Maurice Gueret is editor of the Irish Medical Directory www.imd.ie