Better health service about values, not deficits

Maev Ann Wren ended the States of Health series in The Irish Times last week with a piece headed: "In sickness and in health, …

Maev Ann Wren ended the States of Health series in The Irish Times last week with a piece headed: "In sickness and in health, it's all about values". And so it is.

The challenge, she argues, is to decide between "a consumer-based approach" and a health system which "strives for equity and solidarity". But the choice doesn't begin or end with the health services and the challenge is not confined to those who run them.

The state of the health services reflects the political health of the State. A healthy State doesn't condemn its citizens to damp houses, bleak estates and overcrowded schools; to lives shortened by illness and inadequate services. Poverty and poor health are close relations.

But last week, on another page, Drapier approached both health and political values from a position closer to Charlie McCreevy than to Maev Ann Wren. The series, said Drapier, was required reading for TDs and senators. But that didn't signal a change for the better.

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"The bottom line seems to be that everyone has troubles and our major problem is the capacity of the system. Tinkering with the administration . . . is pointless if we don't have enough staff and beds.

"How to afford this without returning to the deficits of the 1970s and 1980s is the big trick facing Charlie McCreevy (in the Budget). If there's one thing for sure, it's that Charlie will listen to everyone and then do his own thing."

So, in Drapier's view, it's not about values at all. It's about money and deficits, McCreevy's refusal to contemplate reform (or tinkering) and his determination to play the cute hoor (or do his own thing). And if that means following the pattern set in the 1980s, we can tell with certainty where it will lead.

States of Health had the graphs that showed the difference between spending here and in the rest of the EU since 1987.

Ask anybody who has worked in the health service how it is affected by a shortage of funds.

Or how morale seeps away when they realise their service comes a poor second to the big trick and the cute hoor's purse.

Drapier mocks David Beggs of ICTU for his demands on behalf of the workers. It's easier to be po-faced when you're looking for McCreevy's handouts to the rich for the fifth year in a row. After four glorious years of his generosity, they, like Drapier, can afford to whinge.

Drapier's middle class moan is about the Conference of Religious in Ireland. CORI, is criticised with heavy sarcasm: "An economic slowdown is exactly what our religious superiors have been waiting for. Bad times will narrow the gap between rich and poor like nothing else.

"Those of us who do not rule in here by divine right and have to get out there and work to get elected are increasingly irritated by the antics of the community and voluntary pillar."

You can hear the guffaws of the boys and girls of Fianna Fβil and the Progressive Democrats in the members' bar. It's like a rehearsal for Bull Island. Or the time Liam Lawlor got out of the 'joy.

Our religious superiors! Ruling by divine right. The lads in the Law Library will love it. Jasus, Drapier, you're a hoot.

"Drapier thinks Charlie McCreevy had it right about the poverty professionals. Your average 'poveratti' is university-educated, well paid and living far from the places they talk most about.

"Add a dash of obnoxious self-righteousness and you can see why it is more a fifth column than a third pillar."

(For obnoxious self-righteousness, see McCreevy, Harney, McDowell and Dermot Ahern. For "poveratti" see the same.)

"It's time someone pointed out that these little emperors have no clothes and no mandate. Those who have the courage of their convictions can always put their name on a ballot paper. But maybe that's a bit too risky and might mean having to go and do something rather than talk about it."

Drapier claims to know that "several religious are far from happy about the CORI line, which is as far one or two of the larger orders are prepared to go".

Now, hold it there. This is Drapier playing to the gallery with a mixture of cowardice and bullying common to his (or her) kind. Here's somebody, elected or appointed to a public post, with full access to the institutions of the State, the media and the electorate, hiding under a pseudonym - and what a pseudonym - to fire off the cheapest of cheap shots.

This is somebody with brass neck and an obvious worry: health and equity are still in the limelight as an election looms.

The arguments and figures produced by CORI are supported by the figures and analyses of the Economic and Social Research Institute and the surveys of the Central Statistics Office.

Instead of setting equity where it ought to be, at the centre of the debate about health, just as health - not strokery - must be at the centre of the election campaign, the Drapiers of Merrion Street take cover under the skirts of "the larger orders".

I suppose that when Archdeacon Gordon Linney next produces another pointed critique of Irish society they'll set Cardinal Desmond Connell on him.