HEART BEAT:We need to make things simpler and put all the health-related fragments together under one roof, writes Maurice Neligan
THERE IS talk recently about amalgamation of apparently disparate State bodies. On the surface it is hard to see what the Equality Authority and the Commission on Human Rights have in common.
On a more fundamental level, there is a connection. The fact is we cannot have endless proliferation of State bodies and continued expansion of the public sector. This is particularly so as numbers in the private sector, which ultimately pays for all, continue to contract.
The Minister of State at the Department of Enterprise, Trade and Employment, John McGuinness, either putting his own head above the parapet or flying a kite, has done us all a favour by drawing attention to this and pointing out that the present situation is not sustainable.
I suggest in all seriousness another group with overlapping functions that might be merged, allowing us in these straitened times, to benefit from economies of scale.
I refer to the Health and Safety Authority (HSA), Health Information and Quality Authority (HIQA), the Office of Tobacco Control and the Food Safety Authority of Ireland and any similar quangos in the health service - and there are many. I would suggest that these be absorbed into the Department of Health from which presumably they originally calved.
Furthermore, I feel the HSE should go, and its functions be restored to the mother ministry as currently it appears to function as an inadequate shield for an embattled Minister. It has not worked and we should think again. I am proposing that we should make things simpler, gather all the health-related fragments together under one roof, with the Minister taking overall responsibility.
If such a strategy were adopted, we might finally get an answer to the basic question of how many work in the service overall, and what it is exactly that they do. This fundamental fact is unknown. This is farcical and, in these difficult times, intolerable.
Get them all together, streamline the service and orient it in the only way it should go, to look after the needs of the patient. This need not cost any more, indeed sifting the chaff may free money for the primary purpose.
My thoughts were turned in this direction in this Heart Week by a report from the Food Safety Authority about plain old salt. In the Old Testament, we find Job 6:6 - "Can that which is unsavoury be eaten without salt?" - in the New Testament we find Mark 9:50 - "Salt is good, but if the salt has lost its saltiness, wherewith will ye season it?''
On the other hand, the Yellow Emperor Huang Tai warned "if too much salt is used in food, the pulse hardens".
Hard luck God, the Food Safety Authority is going with the Yellow Emperor rather than your old bible. However, as I have repeatedly said, consensus does not equate to certainty, although sadly consensus can often leap ahead of science. In this instance, the work of Prof Arthur Guyton of the University of Mississippi, known worldwide to generations of medical students, described the intricate balance of body fluids in the human and their delicate balance (homeostasis).
He also pointed out that the regulatory mechanism of sodium and water metabolism and blood pressure is extremely complex and subtle. He also taught that the human organism is very well capable of adaptation to conditions of too much or too little salt.
The authority tells us that it has made significant strides in reducing our salt intake by 7 per cent over the past four years. Furthermore, this scion of the nanny state gave lists of "good" and "bad" companies which complied with their arbitrary acceptable limits.
Aldi and Lidl supermarkets and the Vintners Federation were among the baddies, or were, looking at it another way, displaying common sense. The Irish Nutrition and Dietetic Institute weighed in and told us that we had to establish if people were adding salt to their food to compensate for the reductions being achieved in processed foods.
The spokeswoman was quoted as saying that research was under way involving the collection of urine to analyse its sodium content. Was she simply "taking the piss'' as such researches are more than 50 years old?
It was further alleged that the relation between salt intake and heart disease was stronger than that between cigarette smoking and cancer. That sort of nonsense merits no reply.
My advice for Heart Week: plenty of exercise, watch your weight, moderation in all things and if you are unwell, go see your GP.
• Maurice Neligan is a cardiac surgeon