What country is this? Namibia? Botswana? Democratic Republic of Congo? Chad? Have we low literacy levels, low capital investment, low life-expectancy, low investment in infrastructure? Are we the sick man of Europe, unable to feed or clothe ourselves, and dependent on hand-outs from richer countries?
No, we are not. We are - as we all know too well - one of the richest countries in Europe, and growing richer by the second. About a quarter-of-a-million new cars will find their way onto Irish roads this year, up from 180,000 for last year, which in turn was a 23 per cent increase on the previous year. From the days when we imported two VW Beetles and a Cortina every year, we probably buy nearly the equivalent of the entire manufacturing capacity of the British motor-car industry. House prices double between the hot chocolate and the cornflakes. Without blinking, the licensing trade can agree to a 30 pet cent pay increase for bar staff.
Twin greeds
So why are we dependent on the poorest countries in the world, with the poorest medical services and the lowest standards of public health, to staff our hospitals and our surgeries? Is it because we have chosen altruistically to give their doctors work? Or is it because we are torn between the twin greeds of having a comprehensive medical service and the delicious sensation of not paying for it?
Other than putting a giraffe on the moon or re-routing the Gulf Stream by hand, nothing is more difficult than providing a comprehensive medical service, not least because its appetite for resources increases in proportion to the money you feed it. National health services everywhere create an expectation that good health is a natural right, to be supplied to the entire population free of true cost by the government. The science of economics is not permitted in any political consideration of healthcare, which is elevated to a zerogravity planet where the ordinary rules of human behaviour are put in abeyance.
Except, of course, they can't be. That doesn't mean that government after government hasn't tried to relocate healthcare to a world composed of balsa-wood, in which nothing comes crashing to the ground for want of money. But political anti-gravitism can be sustained only by somebody somewhere or other along the line paying the price' and on Planet Ireland, it is paid by hospital doctors - overworked, underpaid and politically impotent. All they can do in protest is to move to societies where they are respected: hence all the Bangladeshis and Africans who keep our health service going.
Servitude
Were any other group to be reduced to the servitude which is the common lot of our junior hospital doctors, the Ministers responsible would be regarded as being on a moral par with cannibals and drug-dealers. Yet, far from being apologetic about the way it has treated hospital doctors, the Government last year actually fought European Parliament proposals to cut the junior doctors' working week to 48 hours within four years, proposing instead that the reduction should occur over 13 years. This contemptible, contemptuous attitude to the single most dedicated group in Irish society should have prompted a national outcry. Nothing of the kind: a squirrel breaking wind would have caused a greater din.
But you can only impose on a sense of duty (or stupidity: they often come to same thing) for so long. At the moment junior hospital doctors can be expected to work a 120-hour week. That figure is so ludicrous that it can only be sustained by pretending that it doesn't exist. So it doesn't for most of us. To a 25-year-old working 40 hours continuously in the Stalingrad of hospital casualty, where every drunk or fool gets free access and free treatment, emigration and respect must seem tasty alternatives.
Yet far from us beginning to recognise that our abuse of doctors is creating a crisis in the medical profession, the reverse is true; medical cards, those passports to a lifetime of free medical treatment for everything that hypochondria can devise, are still distributed in exchange for votes. This is not merely political debauchery. It is idiocy.
The consequence is perfectly predictable: the graduates of our medical schools are nowadays migrating towards political cultures which will reward their skills, their dedication and their intelligence at market value. Canada, the US, Australia, even Britain beckon. Despite having six medical schools in Ireland, which have always over-supplied the Irish need for doctors, and which for decades not merely kept the British National Health Service, the Royal Army Medical Corps, and a large chunk of North American health needs supplied, we are now totally dependent on doctors from Third World countries.
Musical chairs
So: is this the deal? We publicly - and not a little boastfully - give money to poor countries in Africa, and then, very privately, but very persistently, recruit their few medical graduates to staff a medical profession we are too miserly to pay the proper cost of?
Today, July 1st, the annual musical chairs of hospital appointments resumes; but so many Irish doctors have - very wisely - gone elsewhere, that when the music stops, we suddenly find not that there are not too many players but too many empty seats. One day soon - who knows, even today? - patients will start to die because our understaffed, underpaid, overworked medical service will be overwhelmed by the weight of work.
And then who will we blame? The doctors, of course.