RTE's documentary on consultant work practices should be a catalyst for a new system, says Maurice Gueret, who also whips out a spicy bag for inspection
Happy New Year, readers. The dust may have settled by now in consultant car parks after the intrepid RTE Investigates documentary on the working hours of some specialists. Debate will continue about whether cases of work-shirk uncovered in the public service are mere outliers, or represent the tip of a more serious iceberg.
What interested me were the specialties involved - bones, eyes and ear, nose and throat. I think it's fair to say that private practice in these operative specialties is particularly lucrative. And it's fair to say that public waiting lists in these specialties are particularly long. Dealing with the issues raised is probably beyond the HSE and beyond most of our politicians. Let 2018 be the year when we say enough is enough for a twin-track hospital service. We are a tiny country. We have only about 45 public hospitals, and 15 private ones.
They should all be working flat-out in the same service. We should divest ourselves of the old left-right ideological baggage about who runs the service. Competent management, preferably not for much or any profit, would suit me fine. We need to admit that if we want a fair and functioning health service, we wouldn't start from where we are. No health minister barely out of shorts is going to sort out our mess. Almost every other civilised country in Europe has introduced universal health care in some form or other. Let's prove what good Europeans we are and invite some big boys and girls from the continent over to do the very same for us.
When James Reilly was health minister, there was much talk of following the Dutch example. But somewhere along the line, and never quite properly explained, a lethal dose of euthanasia was administered to the idea. Healthcare in the Netherlands is back in the news in recent months.
They made euthanasia services by doctors legal 16 years ago, and demand is growing. In 2017 alone, there were about 7,000 deaths, with the figure climbing now by about 750 each year. The service is provided by voluntary request. Twin requirements are proof of unbearable suffering and no prospect of improvement. In the early days, almost all the requests were from patients who only had days to live. Now this applies to only about 7 in every 10 requests. We may choose in Ireland to close our eyes to the concept of organising our own deaths.
Hitherto, in this country, it has only been the preserve of doctors who have the means to self-administer an early exit. For years, rumours circulated in medical circles about individual doctors who may or may not have made that choice. Our cousins across the sea have led the way. Do we have the courage to join the Dutch in this ultimate expression of personal dominion? I doubt it. But a shot of euthanasia for our less-than-universal healthcare service is long overdue.
Three Italian chip shops within a mile of my house have closed in recent years. Their loss helped to solve the family conundrum as to whether battered fresh cod smothered in spuds should be a weekly or monthly treat. Coinciding with the closure of Dublin's chippers is the rise of the so-called spice bag. This Chinese-takeaway delicacy, a native offering of south Dublin, consists of chunky chips, battered chicken or fish, all shaken together with oodles of chilli, oily peppers, MSG, onions, unspecified spices and curry powder. The healthiness or otherwise of the spice bag, and its calorie count, have yet to be determined. With food-safety folk falling over each other in modern Ireland, I think they're missing a trick by not bringing spice bags to their laboratories. If they contact me, I can provide a comprehensive map of where to get them and an up-to-date price list. Tasting is an optional extra.
I'm not overly enamoured with social media. When your own family tires of having to listen to your every-day opinions, it's safe to assume that the rest of the world may not feel differently in any radical way. But I do like to check my Twitter handle - it's @drmauricegueret - a couple of times a day to see what other medics are up to in their more exciting lives. One doctor I like to follow recently got his plumber's bill reduced from €90 to €50; the plumber reduced his bill following a chat about his bowel issues. Which means the plumber valued the doctor's time at €40, and his own at €50. Just about right.
Sunday Indo Life Magazine