Thursday 26 April 2018

Rude health: Simon's big plan

Now that Fine Gael's front-bench medical team have all stood down, Maurice Gueret asks what hope there is for Simon?

Health Minister Simon Harris. Photo: Tom Burke
Health Minister Simon Harris. Photo: Tom Burke
Dr Maurice Gueret

Maurice Gueret

I felt a bit sorry for Simon Harris this summer. Having exhausted Fine Gael's supply of doctors who wanted to play politics, Enda had to resort to picking a health minister who looks and sounds a bit like a tired junior anaesthetist. Old Doc Reilly was sent packing, to graze in the Seanad. Dr Twomey was gladly welcomed back by his patient flock in Wexford. Meanwhile, blessed Leo of the medical miracles colonised pastures new, seeking to extend Greek-style benefits to the self-employed. It's clear that our short-trousered health minister has been short-changed by predecessors. And there isn't a doctor in sight to help him. That hospital waiting list with half-a-million angry citizens on it has left him a lot of explaining to do.

* Five appears to be Simon's magic number. There are five ministers in his department. There are five hundred thousand sick souls on his waiting list. And, wait for it . . . yes, Simon has a five-point 'specific action' plan. Those in the game aren't impressed. One respected surgeon went on radio to say he'd heard it all before. Another seasoned health commentator described his plans as 'pure guff'. You see, the problem is hiding behind the curtains. No minister in Hawkins House has ever really had the guts to draw them back. Were the public health service to become 'world class' as Simon promised at summer school, there would be no need for two million people to fork out an average €1,200 every single year on private health insurance. Listen to the radio and television advertisements for this product in Ireland. It's sold on the premise of allowing good choice and easy access. The Department of Health sponsors private health insurance. They set it up and mind it carefully, devoting a whole in-house wing to it for decades. The minister's job is to ensure that as many people as possible subscribe to private health insurance. And the most effective way to recruit subscribers is to offer a crap and inaccessible public health service that kills you off as you wait for service.

* That, my friends, is the glaring conflict of interest lurking behind the curtains of Hawkins House. No health minister has ever faced up to it. In cricketing parlance, the minister bats for both sides, and the patient is stumped. Simon's party promised universal health insurance - cover for everybody. They won an election on this vow. Insurance companies duly jacked up the premiums in expectation of future governments footing the cost. That's why your bills are now twice what they were when universal health insurance was first promised. But the minister's party bottled it and rowed back from the commitment. Those responsible for the debacle have moved sideways and are no longer accountable. The chance to introduce a civilised, transparent single-tier health service was bungled by Fine Gael. Whether Simon's new plans boast five points like a pentagon or eight legs like an octopus, they will make no discernible difference.

* I did my bit for Ireland by holidaying at home this summer. We opened the umbrellas in Wexford, and then ordered new windscreen wipers to get us all the way to Connemara. For my generation, the death of Princess Diana was the 'where were you when you heard' moment. Well I was in a surgeon's house at Renvyle, Connemara when news came through of the fatal Mercedes crash in Paris. Nineteen years later, we returned to Renvyle House, and it had hardly changed a bit. The hotel at Europe's most extreme end is still the quirky delight of peaty fires, brown baths, family friendly activities and luxuriant food. Surrounded by lake and sea, its one-time owner encouraged visitors to get out and enjoy the sun as they haven't long to live in it. That was Oliver St John Gogarty, a man who dabbled in everything. Yeats considered him one of the great lyric poets of his age, but then he may have been biased, as Gogarty had successfully removed WB's tonsils in his rooms. Gogarty had trained as an ENT man in Vienna, at the old Krankenhaus where blood groups were first discovered. Gogarty remembered that the hospital policy was to fly a flag on each day that passed without the death of a patient. In all his months in Vienna, he never once saw the flag. Gogarty once remarked that there were no fewer than 19 hospitals in Dublin and that all were completely unmergeable into one. He said there were more vested interests in disease than there were in Guinness's Brewery!

* Speaking of Guinness, I was writing here recently about the link between healthcare and Ireland's favourite stout. One reader tells me that her father had a progressive lung disease, and in the old Adelaide Hospital, this qualified him for a daily bottle of Guinness. After discharge, this tradition was continued on by his GP, and it was sourced each day from an Abbeyleix public house. Another reader's father suffered a heart attack in the 60s. At his hospital in Cheshire, all the men on his ward were prescribed a bottle of stout each day. Kate wrote to tell me that when a grand-uncle of hers was a doctor in England, he was sent a booklet called The Guinness Alice by the brewery to promote their beverage in the middle of the last century. These were parodies of verses and scenes from Lewis Carroll's work, rewritten to extol the medical and restorative qualities of Guinness. The Wonderland of Guinness marketeers claimed that it imparts fitness, makes you sleep soundly, and brings rest to a depressed brain. Alas, it only makes me snore.

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

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