'Pragmatic' politicians are no less ideological

Our leaders justify social inequality on the basis of there being no alternative system

THERE WAS a bit in the last programme of the Bertie series on RTÉ which described him as "pragmatic" and "non-ideological". The implication being that he was unencumbered by any ideological "hang-ups" and responded on an ad hoc basis to events as they arose. Just like most of the rest of us, it is assumed. Certainly just as his successor, Brian Cowen.

Ideology is a bad thing in our political culture. It makes reality fit in with the pre-formatted models of whatever the hang-up happens to be. Pragmatism is far better. No hang-ups there. It's common sense.

However, Bertie was full of ideological hang-ups. Like Brian Cowen. Like the rest of us. And the pragmatism bit? Isn't it odd how pragmatism conforms to the prevailing ideological hang-up? For pragmatism is merely the unconscious application of some or other ideology.

There was widespread unease, if not outrage, at the decision to defer the universal cervical cancer vaccination programme. The basic fairness of the scheme had an obvious appeal and the idea of some (however few) young girls being consigned to die early because of the cancellation of the programme seemed grotesque. Pragmatically, and without the need for any ideological hang-up, we know that to be wrong.

But, but, but . . . how then do we justify an entire social system that consigns thousands to die prematurely every year (well over 5,000 according to Ruth Barrington, former head of the Health Research Bureau) simply because they happen to be poor? And consigns thousands more to live miserable lives, also simply because they are poor?

I met a Fianna Fáil senior counsel last week whose gross earnings from the law and from property are certainly above €500,000 a year. He said he noticed I was continuing to "bang on" about this social inequality "thing".I regret giving the impression of banging on, but this seems to me to be the big issue here and everywhere, like slavery was for a very long time. I have banged on for years about that Inequalities in Mortalitiesreport, which has shown that, for all causes of death, the mortality rate of the lowest occupational class was 130 per cent higher than the rate of the highest. For infectious and parasitic diseases it was 370 per cent higher. For TB it was 300 per cent higher. For all cancers it was 110 per cent higher. For mental and behavioural disorders it was 360 per cent higher. The mortality rate caused by drug dependence was 590 per cent higher; for strokes, 150 per cent higher; diseases of the respiratory system, 210 per cent higher; accidental falls, 510 per cent higher; suicide, 170 per cent higher; congenital malformations and chromosomal abnormalities, 930 per cent higher - and about 300 people die of this every year.

Pragmatists, such as Bertie and Brian, justify the present scale of inequality on the basis of an unconscious ideological hang-up that there is no commonsense alternative to the present system. This system is reliant on financial incentives, which give rise to "regrettable" inequalities. But we do our "best" to ameliorate the harsher effects of those inequalities. We are all in this together and in times of austerity we must all share the pain. Any other arrangement, the ideology holds, will bring untold misery on us all, and destitution.

As for the data on mortalities that I have cited above, this reality cannot be accommodated in the pre-formatted paradigms of their ideological hang-up, so they suppress it. Suppress it not in the sense of censoring its availability, but by fixing the public debate so that this reality never intrudes. For the most part, they are aided and abetted by an ideological media, which cannot accommodate this reality either.

This is quite something of an ideological hang-up: to insist there can be no alternative to a system that consigns boys and girls to die prematurely at twice the rate and more of rich kids simply because they are poor. This is not unique to Ireland of course. The World Health Organisation recently published a report, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. It states: "The high burden of illness responsible for appalling premature loss of life arises in large part because of the conditions in which people are born, grow, live, work and age. In their turn, poor and unequal living conditions are the consequences of poor social policies and programmes, unfair economic arrangements."

We had the chance of changing poor social politics and changing unfair economic arrangements during the boom years, but because of ideological hang-ups we failed to do that. Now, because of the same ideological hang-ups, we are poised to make our social policies and programmes worse and make unfair economic arrangements more unfair.