Tuesday 24 October 2017

Dr Maurice Gueret: Run for universal health cover

Greedy price hikes in health insurance, says Maurice Gueret, is a direct result of the Government's promise of universal cover

Protestors outside Mount Carmel Private Hospital
Protestors outside Mount Carmel Private Hospital

Maurice Gueret

Now that one is in one's 50s, it's quite natural that what was once a foolproof memory fails from time to time.

I was in my local public library the other evening and bumped into a former GP colleague, who asked me how life was since I ceased to practice. I told her the story of the famous French auteur, who wrote that doctors are so busy pulling patients out of the river that they rarely have time to go upstream to see who is pulling them in. It was a way of saying how interesting life and perspective was when you are away from the killing fields. But I could not recall the name of the French auteur at the time – Emile Zola, it was – and I did what dementia patients do so well in the early stages: I covered up this gap in my immediate knowledge with blather.


There are things that I have less difficulty remembering. Do you recall what this ostrich of a Government, both left and right wings of it, said about Universal Health Insurance? Yes, well done. They said we were all going to get it. 'Universal' kind of means everyone, and they promised universal health cover for all in their manifestos.

But one rather obvious elephant in the room is the fact that 250,000 people have cancelled their health insurance in the past five years. Very soon, when the January to March 2014 figures are released, I expect you will be presented with evidence that the number cancelling has reached an all-time high. The reason people are leaving in droves is that it has become so hideously expensive, and the reason it has suddenly got so steep is that everyone is putting prices up in anticipation of the Government undertaking to pay most of the bills. This is not rocket science. This is greedy human nature. Had the Government announced universal funerals, and said it wouldn't happen for 10 years because the Sir Humphreys of this country are incapable of doing anything quickly, you can take it that, by the ninth year of the run-in, most folk would have lost the plot – or at least the ability to purchase one.


Things I thought I'd never see, Chapter One. Candidates from the People Before Profit party posturing in protest at the closure of one of the State's oldest private hospitals. Yes, the closure of Mount Carmel in Dublin's leafy suburbs drew howls of horror across the city, but I, for one, was not really that surprised. A ludicrous sum was paid to the nuns (who still live on the grounds) during the boom, and, with a relatively large staff and never-ending maintenance bills, it has long struggled to pay its keep. The number of baby deliveries was in sharp decline at the hospital in recent years, and it was always clear to me anyhow that not many doctors in the city chose to have their babies there. They tended to prefer the bigger, busier units. In recent years, Mount Carmel went big into promoting its services directly to patients on the internet, but perhaps forgot that their main customers and source of referrals were the GPs, who had supported the hospital from its early days. I often had trouble even accessing a comprehensive list of the specialists who could accept patients at the hospital. The nuns knew their business much better than those who followed. I even recall local GPs being able to admit their own patients for tests, and they could look after them in the hospital. This was encouraged by the sisters. A reader called Tony wrote to me with his own Mount Carmel memory. He was visiting a friend once and noticed a visitors sign on the reception desk: "Please note – children are not permitted in the maternity unit."

He wonders if this contributed to its recent and sudden decline! The sign, he tells me, had been taken down by the time he visited again.


I get a swelling of correspondence each time I mention haemorrhoids, so apologies to those of you I have yet to get back in touch with. I do receive and enjoy your letters and emails, but struggle sometimes with the secretarial duties and personal thank-you notes.

Sometimes, the writing is so indecipherable on the letters that I think it must be doctors who are writing to me. Mr B emailed to tell me an anecdote I had not heard before about Ernest Hemingway. The American's early writing career was as a war correspondent, at a time when a man called Ernie Pyle was the doyen of this species. (I think you can see where this is going!) Long before the world got to know this new force in the literary world, Hemingway would sign off all his war reports as "Ernie Haemorrhoid, the poor man's Pyle."

Mrs A has been in touch, asking me if I knew that toothpaste is a "quick-fix" for haemorrhoid troubles. She may well be looking for a nomination for this year's Nobel prize in medicine, as she tells me that she has "discovered" that a dab of toothpaste is a "good, lasting cure" for them, and she has already advised others about this. She also tells me that she uses a brand called Fiacla, and that it's "great for toenails, too". Now, obviously, I cannot condone the use of any preparation designed for one particular orifice to be digitally transported to another. This sort of behaviour could result in a race to the bottom. Nor can I easily spot an ingredient in most toothpastes that could give relief to a merciless rear. The usual components are abrasives, anti-tartars, a bit of fluoride, flavourants and a few chemicals to give gooey consistency and prevent it drying out. The medical annals I possess are quite empty on the topic of toothpaste and piles, so I may have to refer to Doctor Google and tell you more next week.


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