HEART BEAT: "The rule is, jam tomorrow and jam yesterday- but never jam today" - Lewis Carroll, Through the Looking Glass.
This seems to be the current state of affairs. We are reminded constantly of all the benefits that have been bestowed on us lesser folk by our Ruling Elves. Many of these so called benefits, eg low taxation, do not bear close scrutiny, but the Rulers hold that if you repeat these things often enough, people will come to believe them.
As for jam tomorrow, there is an election coming and we are going to be sick of jam of every possible variety by the time it is over. I await the menu to unfold although in truth, it has already begun.
"Never jam today" I would propose as the motto for the Minister for Trolleys and her acolytes, the HSE and the Department of Health. I am sure that the chief herald of Ireland could devise an armorial bearing that would encompass their sterling qualities and emphasise the chaos they have created. Solving the accumulated problems of the health service was never going to be easy and prompts a return to Through the Looking Glass: If seven maids with seven mops, Swept it for half a year, "Do you suppose" the Walrus said, 'That they could get it clear? 'I doubt it' said the Carpenter, And shed a bitter tear.
Even when the seven maids were supplanted by a vast army of administrators, there was no hope of reform when those responsible chose and still choose to ignore the basic problem, pointed out repeatedly by doctors, nurses and those working with patients: There are not enough beds.
It was with frank incredulity that I heard the Minister for Trolleys declaim with a straight face that there is a crisis in the provision of A&E services and that this constitutes a national emergency. The same was repeated by the Taoiseach.
I would like to thank you both for waking up, but it is not as simple as that. You both knew all along, and furthermore you ought to have known, that your feeble attempts at reform were not working. These reforms invariably called for "expert" groups to be set up to endlessly analyse the problems.
Reports rather than reality are the hallmarks of recent incumbents of the Ministry for Trolleys. Brennan, Hanly and Prospectus etc, the list is endless. Needless to say, no action will be taken on any of the above with an election looming.
The many worthy folk who participated honestly in such planning must now wonder why they bothered. There is no contrition here, no admission that their plans and proposals have not worked and no acknowledgement that they were simply wrong. Instead there was double talk, obfuscation and denigration of those who pointed out the scandalous situation over which they presided, but apparently for which they bore no responsibility. There was talk of acute medical admissions units, talk of admission lounges. Both of these of course are merely what the nurses and doctors have been calling for - more beds. There were suggestions that if the doctors worked after 5.30pm, there would be no problem.
Acute hospitals never shut down and laboratory, radiology and medical services are always available. I have repeatedly pointed out that night and day exist even in hospitals and cannot be abolished by self-serving politicians seeking re-election.
Likewise, GPs run evening surgeries and provide night cover in areas where such is safe. No amount of bluster, arrogance and bombast can conceal the fact that unsafe areas exist.
We are told of X number of patients who could be discharged, but have nowhere to go. We knew that. Whose responsibility is it to ensure that they have somewhere to go? It is again a matter of not enough places within the system to cope with the needs of the people and it is your responsibility.
There is no acknowledgement that the situation is further falsified by the National Treatment Purchase Fund buying patients off the waiting lists into private, for-profit institutions. This you have the gall to portray as success, when to any thinking person it simply points out the failure of the system over which you preside.
Population growth, increasing litigation and consequential defensive medicine, coupled with the removal of beds from the system, led inexorably to the situation in which we find ourselves now. No manipulations of figures and statistics can hide our failure to deliver a decent service to our people. Respected people have expressed in public their outrage at the situation and there has been a huge response from ordinary folk. Now there is an election looming.
What to do? Blame the doctors, Minister, a tried and true formula against a soft target. Maybe it was once, it will no longer do. I was very conscious when I wrote about the scandal in Drogheda that some folk would use it to attack my profession in general. It gives me no satisfaction to say that I was right.
Dr John Hillery in a moderate response to what I wrote stated that some might think that my point was against lay representation on the Medical Council. It was not, although with a lay majority it would cease to be a Medical Council.
My point is that I feel the proposed plans for reform as laid out so far are unacceptable to the profession. The postulated use of agents provocateurs to quiz hard-working doctors is not merely unwise, it is contemptible. Those leading can easily become carried away by rhetoric and lose touch with their constituency.
As for the politicians, the health service and the election, I quote Franklin D Roosevelt: "No man and no force can abolish memory."
Maurice Neligan is a cardiac surgeon.