Thursday 22 March 2018

Rude health: One for the master

What do our maternity hospitals and 'Downton Abbey' have in common? Maurice Gueret finds somebody in charge

The BT Young Scientist and Technology Exhibition at the RDS.
The BT Young Scientist and Technology Exhibition at the RDS.
Maurice Gueret.

Maurice Gueret

With a general election around the bend, I thought we'd cast a cold eye each week on the policies of political parties that have yet to be given a chance to fail in Health. Renua Ireland were first out of the blocks, with a manifesto that devotes five pages to healthcare. They are proposing a National Health Forum to "generate a permanent national dialogue with all stakeholders in the sector", calling it, "the only realistic way by which the engagement and buy-in necessary can be garnered".

The gas used to write this sort of rot should be bottled for anaesthesia. It sent me to sleep instantly. Renua say that those working in the health service "have shown a huge appetite and capacity for reform under progressive leadership". One wonders exactly whose progressive leadership they were thinking about. After two decades of constant tinkering with and renaming of permanent structures, I would say that doctors, nurses and the rest would rather a piece of permanency in the service they provide.

The new Master of Dublin's Rotunda Hospital was a popular guest on the first Late Late Show of 2016. Now that's a permanent position that Professor Fergal Malone occupies - for seven years, anyhow. The Master's job is over 260 years old and has its roots in a Royal Charter granted to the hospital's founder, Dr Bartholomew Mosse. The job combines the roles of clinical and hospital management in one person. It has been, and remains to this day, a resounding success. So much so that it was copied by Dublin's other two maternity hospitals, at the Coombe and Holles Street. Strangely, it has never grown legs in the rest of our health service. Politicians believe that the devolution of too much power, responsibility and time in the hands of one person may be severely injurious to the public. When the person is a respected doctor who has the esteem of his peers, the trust of his patients, and no need of friends in elected office, the dangers to national well-being are all too clear for our gombeen men. And more is the pity. We have had over 20 health ministers in the last 50 years. Not one has served seven full years. Need I say more? It would take a brave political party to add medical masters to their manifesto.

This year could be an interesting one for Ireland. Half of the population is looking forward to flag-waving rhetoric, marching boots, and the firing of blanks at both Easter 2016 in Dublin and Euro 2016 in France. The other half is wondering how they will cope without Downton Abbey in winter. I confess to being a late convert to the television drama. They had been recruiting for five seasons when I saw my first episode. But the miracle of the modern boxset means that I am able to hold my own at dinner parties, whether conversation turns to the pastry-making of Mrs Patmore, or the medical acumen of Doctor Clarkson. There was hardly an episode in the 52 that didn't feature a healthcare issue of some kind. What began with a multiple drowning, the poorly treated limp of Mr Bates and the coital death of a young Turk in Lady Mary's bedroom, finished with an incorrect diagnosis of pernicious anaemia in Mrs Crawley's beau and a familial palsy that afflicted the hands of Carson the butler. Someday, I might get around to writing that bestseller, The Ailments of Downton Abbey.

I make two trips to Ballsbridge each January. As the years pass, I find myself dreading one and looking forward more to the other. Funderland is one I used to love, but could now do without. There are no warning signs on the rides about the dangers of middle-aged men indulging in the available tortures, but I have imposed a personal ban of late, and am more than happy just to pay the bills and marvel at the elasticity and lack of nerves of youth. The trip I look forward to is the BT Young Scientist & Technology Exhibition. It never disappoints. I didn't rate the project from my old school that looked at replacing doctors with Nintendos, so I awarded top marks elsewhere. What I learned from this year's 550 projects is that swimming could be a good sport for asthmatics, a fifth-year student may have discovered a test that signifies cancer of the gullet is spreading, and that girls outnumber boys at the Young Scientist & Technology Exhibition by about two to one. Things can only get better.

Just over half of the secondary schools in Ireland participate in said exhibition each year. When you see the talent on display, a principal would need to have a pretty good excuse handy for a no-show. Three schools in Cork had almost 50 entries between them. Not everyone is a scientist. Perhaps not too many school principals rise from behind the smoke and mirrors of laboratory benches. But I do worry that 200 schools cannot send a single pupil to compete with their peers at the nation's favourite science event. Must try harder.

The best temperament for a good surgeon would make a fine topic for a budding young scientist. Only once in my life did I have to pass under a scalpel. For the delicate procedure, I chose a Dublin surgeon who was as passionate about playing the oboe as he was meticulous at his day job. He played all the right notes, with a bedside manner to die for. He had one rival for impeccable manners, a famous surgeon in Ulster. When things hotted up in his Belfast theatre, he would only say, "Oh deary me!" And if things looked bleak, he'd rise one semi-tone to, "Oh deary, dear, deary me!"

Dr Maurice Gueret is editor of the Irish Medical Directory

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