Tuesday 20 March 2018

Rude Health: Simple for Simon as youngest minister takes on health

Our new minister for health has age and goodwill on his side, writes Maurice Gueret, who has advice for the new boy

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

Maurice Gueret

Well, thank goodness we have a Government at last. Nobody knows what direction it will take, but the Taoiseach's selection of independent-minded ministers may give us a clue as to what parts of the country might benefit. If your wish-list includes fast-speed broadband up in Roscommon, a Luas track up to Enniskerry, and extra childcare facilities for Tallaght, this could be Enda's best little Government ever, in the history of the State.

Those of us who play doctors and nurses are watching our new puppy with delight and wondering how quickly we can train him in. Boy Simon may have hopped into Hawkins House in short pants with a recently completed vaccination schedule, but he comes with a reputation as a clean-shaven young man in a hurry. Those close to the ether fumes of Fine Gael leadership whisper the name of young Harris as one who might usurp the prime-ministerial ambitions of more talked-about candidates.

For the second time in a row, the Taoiseach has appointed the youngest member of his cabinet as minister for health. His pick has much to learn, and fast. The chamber of Greystones Town Council and a junior ministry for flooding may be excellent primers for development of political nous, but Health has a language and powerplay all of its own.

Young Harris will need urgent tuition in the dark arts from the very best. He will need to know that there are two types of oncologist, mixed up at your peril. He will learn that an otorhinolaryngologist and an ear, nose and throat man are one and the same. At prolonged meetings of EU health ministers he needs to use the word magenschleim-hautentzundung (German shorthand for tummy upset) if he wants to escape the tedium and get back to his teddy bear at the hotel. Young Harris is in the very interesting position that he has no local acute hospital to support. It's traditional for health ministers to splash the cash in the home parish, but Simon's constituents in Wicklow and East Carlow have to go outside their counties to access acute care. St Columcille's in Loughlinstown and St Michael's in Dun Laoghaire have been life-savers for generations, but both hospitals have been on the 'deprived and critical' list for some time. The focus and funding has been shifting further away from his patch up to St Vincent's at Elm Park.

With the exception of the campus at Letterkenny Hospital, there won't be too many watery floods for the new minister to deal with. There will be floods of a different kind. The begging letters and emails are already piling up on his desk. The civil servants want him to sign the oath never to use the word 'change'. The consultants will offer to examine him and warn of their fees in advance. The nurses will rearrange his pillows for an extra hour off. The GPs want him to appreciate their forgotten talents. The pharmacists want to be his best friend. And on it goes and goes and goes. The former minister for flooding will discover that there is no shortage of drains in healthcare. He will learn that the words 'service' and 'salary' are interchangeable. He cannot improve one without improving the other. And so most things remain the mediocre same. My wife has wanted me to be minister for health for decades. "Nobody knows as much about it as you do," she whispers softly into my ear. Which is one good reason that I could never do the job. And the reason young Simon could possibly do a very fine job indeed.

The fluffy elephant in Simon's bedroom, however, is that Fine Gael, like Fianna Fail before them, has failed miserably in Health. Micheal Martin recreated the dinosaur with his HSE. Simon has been given the job of dismantling it, or changing its name to something else. Fine Gael failed to live up to the promise of universal health insurance and free check-ups for everybody. Private health policies were quite reasonable when Dr Reilly announced their plans for universal coverage, but the mandatory Irish delay in implementing any plan gave insurance companies a chance to double their premiums. This bungling means there is no universal access, and those who already had cover are now struggling to pay it. Many have either dropped out or dropped down to policies they don't really understand. Like the one that offers an extra slice of toast on public wards if you pay an excess yourself for the breakfast.

I once worked for Denis Gill, now retired professor of paediatrics at Temple Street Hospital. He was simply the best teacher of children's medicine in Ireland and beyond. His common sense and his intuition about his little patients and their parents was legendary. He also had that great gift of making the complex simple and making the thickest of junior doctors feel that they had something to contribute. Alf Nicholson is his successor as professor and he shares that ability to teach well.

Professor Alf has just co-authored a book with writer Grainne O'Malley, called When Your Child is Sick: What You Can do to Help. Published by Gill Books, this is an excellent encyclopedia of everyday parental worries. Chestiness, tummy troubles, foreskin ailments, skin rashes, restless sleep, food troubles, growth worries - they are all covered. In my childhood, every sensible Irish mother had a reference book called Baby and Child Care by Dr Benjamin Spock. When Your Child is Sick is a most worthy successor.

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


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