Monday 23 October 2017

When I grow up

Doctor Varadkar has wanted to be Minister for Health for nearly 30 years, says Maurice Gueret, so what's his plan?

Maurice Gueret
Maurice Gueret

Maurice Gueret

All the talk in medical circles is about one topic these days - Leo's cosy chat with Miriam on the radio. Admiration for Dr Varadkar's courage has been universal.

It cannot be easy for an innately shy, decent and grown man to explain to the nation that he has wanted to be Minister for Health since the age of seven. I found this far and away the most revealing part of Leo's interview. The image of a seven-year-old actually wanting to be Minister for Health is hard to take out of the head. We know that British prime minister Harold Wilson had his photograph taken outside 10 Downing Street at the age of eight, and it's common knowledge that one-time Tory leader William Hague learned election results by heart as a boy, and read Hansard in bed every night. But a professed ambition for any Irish politician to be Minister for Health is highly unusual. Seven-year-olds might well profess a longing to be Taoiseach, President or Commander-in-Chief of the Galaxy. But Minister for Health? That's the sort of behaviour in a child that causes sleepless nights for parents. Perhaps Leo gently understates his childhood ambition, so as not to  upset Enda.


Leo grew up in a traditional medical 'doctor and nurse' household. If my mathematics is right, he turned seven in 1986, the final year of Barry Desmond's tenure in Hawkins House. Health was very much in the news back then, and doubtless discussed over the bacon and muesli each morning. Minister Desmond was modernising Ireland's laughable contraception laws, Aids had arrived on our shores and savage bed cuts had begun to pay unending health-union demands for higher salaries. Seven hundred acute hospital beds were lost during Mr Desmond's reign. He had planned to close Monaghan hospital, but fiery local opposition forced a rethink. The next Minister for Health was a Monaghan GP, Dr Ruairi O'Hanlon. He reprieved his local hospital, and many more rural ones, but hospitals and acute beds all over Dublin were closed nevertheless. Between 1987 and 1993, the east of the country lost almost 30pc of its beds, and many of its finest hospitals.


Now it has been obvious for many years that Leo has been engrossed in politics. As a young fellow, he liked nothing more of an evening than sitting in the studio audience of Questions & Answers and posing questions that were prepared in advance by his party. Yes, he is a medical doctor. But few of his colleagues know what plans he is actually secreting for the Irish health service. He has been a county councillor, a TD, and then minister, since qualifying in medicine, so his experience of working in the health service is reasonably limited. Just recently, he made a major howler when he said there were no catchment areas in Irish healthcare. This revealed precious little experience of mental-health services, where your care and consultant is often decided by the number of your house and the name of your road. Catchment areas are also a fact of life in many Dublin hospitals. Starved of beds, they regularly write to GPs advising that they cannot see patients from outside their catchment areas. But we all make gaffes. My spies in the realm of transport tell me that Leo was a smart and excellent minister, head and shoulders above the usual. He was sharp, decisive and quick to grasp issues. They have sorely missed him since the reshuffle. Fine Gael's plans in Election 2011 for universal health insurance, trolley-free hospitals, free GP care and annual check-ups for everybody, are all in tatters. What they have achieved is a doubling in the cost of private health insurance. Insurance companies like nothing better than plenty of advance notice of what's coming down the road.

So what will Leo do for health? Well he's there now since last summer. Best thing he could do is tell us that he wants to stay there for the long haul. If he becomes Taoiseach, he might retain health as his brief. It's not easy, but it's not that complicated either. It's about looking after sick people as humanely as you can. It helps if you can see everything from the point of view of the patient. You have a huge budget and 100,000 workers, too many of whom never see actual patients. I'm sure Leo can do that. But he needs at least a decade. Otherwise he is wasting his time, and ours.


I am a great fan of the National Archives, who collate and store many of the treasures that homespun revolutionaries didn't burn. They even hold some hospital collections dating back to the 1700s. They are about to launch into a wonderful project that will visit over 200 hospitals in Ireland and survey the records hidden in their attics and basements. Supported by the HSE and sponsored by the Wellcome Trust, the researchers want to gather detail of what's actually there, so that we can formulate a national policy on the long-term preservation of health records. It's a wonderful thing to do, and you never know, they might just find that chart that's always missing when you visit outpatients!


Apologies for the brevity of our medicine in Irish today. Still hungover since Christmas. I am told that Peig described a man with a hangover with the following line: bhi driodar na meisce fos air which loosely translates as: he has the slops (or residue) of drunkenness on him. It's waterworks next week.

Dr Maurice Gueret is author of 'The Doctor's Case'

Sunday Independent

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