Taoiseach must crack the whip

HEARTBEAT: The response was predictable

HEARTBEAT: The response was predictable. This was the rejoinder from the Minister for Trolleys to the survey which placed us second last in the European league of achievable health standards.

OK, maybe some of their data are a little bit out of date. This they maintain was not their fault, as they were unable to obtain relevant up-to-date data as it was not supplied them despite their request. This I can empathise with. Some data about the terminal illness of the health service are simply not available.

For instance, where are the hospital waiting lists now? They are buried in the maw of the unaccountable National Treatment Purchase Fund (NTPF).

The same NTPF who are advertising for business in the media, using your money. The same NTPF proclaimed by the Minister to be a great success.

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It is far from that; it is in fact in my humble opinion, a great scandal. By its very existence it diverts money away from where it is desperately needed in our main hospitals. It scatters patients from the tried pathways of referral to venues unselected by the patient and which may well play no part in the vital matter of post operative follow-up.

It operates in the shade, trying to cover its inadequacy with a thin excuse of commercial sensitivity. Don't give me the childish bit about "x" hips, "y" hearts, "z" other treatments, have been made available because of the fund.

The answer is that these people should have been treated where they were referred and if there were problems of capacity, these should have been addressed. Instead, the existence of a bed shortage was stubbornly denied, sadly by some who should have known better.

Instead of investing in these and their support staff the money was diverted to this secretive qango. The fact is we don't know now how many patients are waiting and where they are. How is that for accountable Government? It is a deliberate attempt to suppress unpalatable facts.

The report states what the caring professions have been saying all along. We do not have enough beds and have a ratio of 2.9/1000, population as against a European Union average of 4.1. God knows I am sick of saying this, but it is the root cause of all our problems in the hospital service.

Some kind or unkind person sent me a copy of an interview, given by the Minister to a Sunday newspaper last month. It is a mixture of wishful thinking, fable, aspiration and anecdote. It contains priceless gems, "junior doctors are supposed to be doctors in training, and in Ireland they train for longer than is necessary. In my opinion many of them are probably suitable to be consultants".

Is that so? When I am sick, please let me have a properly trained and experienced consultant. I don't want somebody who is a consultant because the Minister for Trolleys thinks he/she should be.

I don't understand the shambles that comprises our present service but such was inevitable when its salvation was entrusted to those who created the problems in the first place.

Its intangible, weaving, seldom interlocking parts are always just out of focus. We need clarity and above all accountability. We are getting neither. We know this and it has been reported from outside. We must not be deluded by the self serving defence of the indefensible.

Our Taoiseach is a very astute man. He is a kind, friendly person and this I know. He is above all a very accomplished politician. He has just dealt in masterful fashion with the rumblings of dissent on his back benches, indeed in such a fashion that those dealt with, don't seem to realise it yet.

Now this pragmatic, conservative, socialist, radical, republican politician could never be accused of being an Empire loyalist. I would accordingly be mildly surprised if he were familiar with the Barrack Room Ballads of Rudyard Kipling.

If he has not read it already, I would recommend the poem, The 'Eathen. It is you Taoiseach, as the Colour Sergeant.

'E learns to do 'is watchin' without it showin' plain;

'E learns to save a dummy, an' shove him straight again;

'E learns to check a ranker that's buyin' leave to shirk;

'An 'e learns to make men like 'im, so they'll learn to like their

work.

Trouble is Taoiseach, some of the dummies are incorrigible and one must wonder if in the ranks of the disgruntled or in the words of P.G Wodehouse "far from gruntled" backbenchers there might not be some better replacements.

Yes, I know it is merely re-arranging the deck chairs on the Titanic but it might look tidier. It is certainly reaching the time for your juniors when "sauve qui peut" becomes the cry of the day. You can understand that.

Maurice Neligan is a cardiac surgeon