Sunday 24 September 2017

Unhealthy legacy: rating our best and worst health ministers

Who were Ireland's very best and worst health ministers, asks Maurice Gueret, as he shakes his bottle of vinegar

Dr James Reilly, former health minister. Photo: Stephen Collins
Dr James Reilly, former health minister. Photo: Stephen Collins
Dr Maurice Gueret

There is no party quite like Fianna Fail for hanging dirty linen up in public and forgetting to wash it. One prominent Dublin member was quoted in the papers recently as saying that 'several people' had said to him over the years that party leader Micheal Martin was the "worst minister for health we ever had". A career in diplomacy beckons.

For what it's worth, I'd certainly have him well up my list of poor health ministers. When the service needed radical surgery and the country was awash with borrowed money to do it, he chose a nip, tuck and a bit of Botox. The HSE is his legacy, and he left behind a health system far more dangerous than a smoky pub. Dr James Reilly would be another major contender. Fine Gael excited the country with its plans for health insurance for all. But insurers simply jacked up premiums, Reilly's wheels came off, and we are all paying the cost today.

Best health ministers is an interesting category. Dr Noel Browne meant well and aimed high, but he was not an effective politician. His ministerial career lasted just three years. But he did have his finger on an important national pulse. He failed to understand why the State did not pay salaries to its doctors like they paid to postmen. As he put it succinctly, the doctor gets "a sweetener in the form of a fee", every time he drops in a letter. This he saw as a driving force behind the rising cost of health services without any improvement in efficiency. I don't think Mary Harney met expectations in the health brief, but she did more for the health of the country as environment minister than any other, with her 1990 ban on Dublin's smoky coal. Her measure got only a fraction of the publicity showered on the smoking ban, yet saved as many as 100,000 lives in the last 25 years. For bravery, it's hard to beat Barry Desmond. He had to preside over dreadful cutbacks in the 1980s, but when then Taoiseach Garret FitzGerald tried to reshuffle him from office, Desmond stuck to his desk like a limpet. He was that rare health minister. He was blunt, too. In the first line of his memoir, he said that he merely did what all sensible Cork men do. He bought a one-way ticket to Dublin. I am interested in your views on the best and worst health ministers. There have been about 25 of them in all, and you can drop me a line at PO Box 5049, Dublin 6w, or email me at mgueret@imd.ie

* They say that doctors who lose their hearts to nurses are the true romantics of our profession. Those who marry each other may be keeping one pupil dilated for the bank statement. Having fallen under a moonlit medicinal spell at a garden party in the Nurses' Home, I'm in the former camp. The home is still available for anniversaries. It's now a trendy hotel with oddly shaped furniture and excellent nibbles. It came to mind as I read a recent obituary for a well-regarded interventional vascular radiologist. That's the doctor who organises X-rays when you have tubes and balloons inside your blood vessels. He, too, had married a nurse. They first met while working together in the emergency department of St Thomas' Hospital in London. She was in the middle of dressing a wound in the 'pus house', which was the colloquial medical term for the sepsis room. Seizing his opportunity, the young casualty officer popped his head in to ask her out on a date. I'm guessing they didn't return to the pus house for anniversaries. But for many visits after the date, the patient who witnessed the proposal would enquire how the romance was going. They managed very nicely for over 50 years.

* Britain's oldest man passed away some weeks ago. I'm sure he has been replaced by now, but his story is interesting. John Mansfield died in his 109th year, just 16 days before his birthday. For most of his life, he worked as a farm labourer, and managed to plant a tree at the age of 98. He supported Manchester United, and could remember when Wayne Rooney last scored a goal. The press loves to headline stories of great longevity with some health claim or other. In the case of Mr Mansfield, his long life was put down to a full English breakfast each morning, and a fondness for vinegar cures. By all accounts, he used vinegar to cure every sort of ailment and was always recommending it to friends and family.

* We are trained in Ireland only to put vinegar on our chips. Posh families might use it to make salad dressing, pickle beetroot and gherkins, or clean their windows. But vinegar is an interesting and undervalued liquid. Its main parts are the relatively mild acetic acid and lots of water. Different varieties can be made from various fruits, plants, beers and wines. In medicine, it can be used topically to relieve some jellyfish stings, and has some anti-wart properties when combined with salicylic acid. Vinegar's enamel-ripping effects aren't so popular with dentists, but it has been suggested that we consume less food when vinegar is on it. The legendary Vermont physician Dr DeForest Clinton Jarvis, who wrote a million-selling book on folk medicine, always promoted apple cider vinegar as a great tonic. He promoted the idea that 50-year-old people are like 50-year-old houses and need to rebuild themselves as they might rebuild houses of the same vintage. Dr Jarvis's Folk Medicine book is still widely available, and contains some fascinating theories about the benefits of combining honey with apple cider vinegar, closing windows and what humans can learn from animal health. Perhaps the doctor would keep away if we reduced tea imports, stopped murdering bees and fermented a few more of our apples.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

drmauricegueret.com

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