HEART BEAT: Last night I experienced again at first hand the A&E services in Dublin. I had occasion to bring a patient to St James's hospital as a semi emergency.
It was a calm, efficient and well-organised unit, with an early separation of trauma and critically ill patients on the one hand, and what could be termed "the walking wounded" on the other.
My patient belonged to the latter grouping, although the nature of the complaint required early assessment and/or treatment. This was done quickly, compassionately and carefully.
I cannot say enough for the professionalism, kindness and courtesy of all the frontline staff I met - porters, reception, nurses and doctors. This was cheerful and undaunted by an enormous work load, with patients requiring admission being transferred to the mandatory trolley.
At one stage a sister or staff nurse appeared to conduct a roll call of the waiting patients. She told everybody honestly that the waiting time for the less-than-critically ill was now eight hours before assessment. Clearly this was not the fault of herself and her fellow nurses; they were working non-stop. The assembled patients therefore accepted this stoically and with infinite patience. Alcohol and addiction did not seem to play a major role in this quiet group of the afflicted. I was assured, however, that this was a quiet evening and that it was early yet.
My heartfelt thanks to you all - the kind lady on reception, the nurses and doctors who looked after my emergency and all the other patients. You and your likes are all that keep this disgraceful service afloat.
Patricia Hewitt, Secretary of State in Britain's Department of Health and Social Services (DHSS), faced up to the nurses last week, to assert progress in the NHS. Such progress was not discernible to her angry audience and they made their displeasure felt.
They lived with the reality, and no amount of obfuscation or grandiose claims would compensate them for the dismal present. At least Ms Hewitt had the guts to face them.
For our own Minister for Trolleys, there will be no ugly confrontation with the nurses of the Irish Nurses Organisation, as they gather for their annual conference. She has a prior meeting in America.
As the INO conference is held in the same week every year and as no Minister has missed addressing this important group over the past 30 years, somebody was obviously very remiss in marking her diary.
However, she sent them clear messages of her regard. As all your salaries have gone up by 60 per cent since 1997, your pay claim is not sustainable and will not be paid. Have a happy conference. PS You can forget about a Dublin allowance as well.
This is one of the oldest ploys in industrial relations. Sixty per cent rise, but 60 per cent of nothing is nothing. Just as well the nurses can't count. These are the silly folk who can't do their sums on the number of trolleys in each hospital every day. They keep getting it wrong and the better paid administrators who haven't been up all night have to do it for them.
As for the Dublin allowance, I honestly think that everybody would accept that they are a special group.
As for the final pronouncement: "Well anyone that thinks I'm afraid of any group would want to think again."
My late father would have described this type of bravado as "whistling past the graveyard". Our nurses have been scandalously underpaid for years, Minister, and if you can divert your attention from establishing a right wing two-tiered health service for a few moments, you would see that this is indeed the case.
Sadly, however, I am afraid that it will require someone bigger than you to do anything about it.
Meanwhile apparently, it is as Euripides put it circa 450 B.C. "It's better to be sick than nurse the sick. Sickness is single trouble for the sufferer: but nursing means vexation of the mind and hard work for the hands besides."
The Minister for Trolleys tells us that we are to have a lay majority on the Medical Council. She would have a role in the appointments but she stressed that it was not her intention to appoint her friends.
Sure we know that Minister. Hasn't that always been the way in Irish political life? Aren't we long past that jobs for the boys attitude?
Trouble is that whatever you call it; it will not be a Medical Council. I don't know any doctor who supports the proposal, even the President of the Council. But it needn't matter unduly.
The Minister for Trolleys isn't afraid of doctors, big ones, little ones, boys and girls; the bigger they are the harder they fall. In fact, she doesn't seem to be afraid of anyone. You had better watch out God, she might be after your job next; much as we would hate to lose her.
Finally folks, if you have nothing better to do, I recommend that you read the Minister's article, Hospital beds plan is not bad value for the public, in this newspaper (May 4th).
I know you will read it with an open mind, but I would ask you to bear in mind two salient facts. Firstly, are not all citizens of the State entitled to a public bed? Secondly, half of the Irish public carry private health insurance. If you cannot work out the contradiction of these basic premises in her article, I'll give you a hand next week.
Maurice Neligan is a cardiac surgeon.