Monday 16 September 2019

Brendan O'Connor: 'Leo versus the nurses shows his missing bedside manner'

For a guy who's supposed to be a master of spin, the optics on Leo's attack on healthworker holidays are not great, writes Brendan O'Connor

MISDIAGNOSIS: Leo Varadkar should be concentrating on the people who manage HSE resources
MISDIAGNOSIS: Leo Varadkar should be concentrating on the people who manage HSE resources

You'd wonder if Leo felt the need to assert his straight-talking, people-who-get-up-early-in-the-morning credentials a bit last week. Peter Casey, of all people, seemed to have stolen Leo's clothes in recent weeks, and there were mutterings that the Taoiseach formerly known as ''Tory Boy'' had become too social democrat.

For whatever reason, Leo decided some straight-talking was required, a bit of good old-fashioned common sense. And he probably thought he was safe enough blaming everything on health professionals. You could easily judge that health professionals are not the most popular people around right now. There was a very simple paradigm presented around the CervicalCheck scandal that a paternalistic patriarchy of doctors knew better than women did what was good for women. So misogynistic were these medics that they didn't even give women information about their own health. So puffed-up demi-god medics are not flavour of the month in the ever-changing court of outrage-led public opinion. And, of course, you're always safe having a pop at the HSE. They were the ones who mismanaged it all. And then Tony O'Brien had the gall to come out last week and make it all about him.

And the politicians? They were the good guys, the ones who had to come in and clean it all up. Simon Harris, the millennial messiah who will not rest until he has delivered abortion by January 1 whether the system and the GPs that are supposed to deliver it are ready or not, was centre stage in outrage around CervicalCheck. He emoted all over any media outlet that would have him, wrapping himself firmly around the survivors.

In general, young Simon is becoming quite the PC prince who ticks all the right boxes. In one radio outing last Wednesday, he managed to mention mansplaining and also referred to people manning, or womanning, phonelines. Though perhaps the phrase he was looking for was ''personning'' the phones.

Leo had a bit of a false start on the emoting around CervicalCheck, seeming a bit cold at first, but he got the memo then, and joined in with gusto.

You might even speculate that the lads thought they had discovered a new paradigm for dealing with the ongoing slow car crash that is the never-ending health crisis in this country. Blame it all on do-nothing docs and faceless officials. For too long, they clearly decided, health ministers have borne the brunt of being held responsible for the health system in this country.

From now on, blame would be apportioned where it belonged, to overpaid health professionals and their incompetent managers.

So Leo decided to try it again by launching a pre-emptive strike against the inevitable hospital crisis in early January. And he possibly had a point when he said that at times of peak demand, organisations should marshal all their resources. But he possibly misread how it would play.

Firstly, he seems to have forgotten that the Dail takes four weeks off and that the political system essentially shuts down at Christmas. He also seems to have forgotten that one in five of consultant posts in this country lies vacant, that there are hundreds of vacancies for nurses in the A&E system alone, that the primary healthcare and GP system is on the verge of collapse in many parts of the country, and that's before the GPs start doing abortions as well.

He possibly forgot as well that the health service will have overspent by €700m in 2018, which most people find mind-boggling.

Next year, the State will spend €17bn on health, which is about €3,500 for every man, woman and child in the country. That means that if you are a family of four, about €14,000 of your taxes goes on health, and you possibly pay for health insurance on top of that.

Our health spend actually dwarfs, for example, our education spending. When you take in total expenditure on health in Ireland, the OECD says it's actually €4,700 per head of population. And, right or wrong, people feel that for that kind of money, we might expect a functioning health service.

But most of all Leo seems to have misread the sentiment on this one. This wasn't your usual easy doctor-demonising. It's one thing to paint a picture of oily, high-earning demi-god consultants hitting the golf courses of Portugal or going for bracing walks in Roundstone followed by hot toddies as they spend early January laughing jovially about the plebeian patients they have to deal with.

But when most people think of hospitals at Christmas, we think of harried but saintly nurses, struggling junior docs who haven't slept in 24 hours. We think of the endless patience and kindness that most of us experience, even in chaotic hospital environments. We think of people who go above and beyond in impossible situations to make it feel a bit more like Christmas for sick children. We think of grace under pressure, of humanity maintained even in impossible circumstances. We think of times when we ourselves were at our most vulnerable and afraid, and we think of the tenderness and reassurance we were offered. We think of people who do jobs most of us would not have the patience or the stamina to do.

So to conjure some daft notion of nurses off sunning themselves in Barbados while bedlam reigns in the wards in early January probably came across like a cheap shot.

There are very few noble vocations left in the world. Priests and cops and even teachers have all fallen off their pedestals to varying degrees. But nurses, and many docs, especially younger ones, are still regarded, whether they themselves like it or not, as not just being in it for the money or the career. And in the world we live in, where selfishness is the default position workwise, we have huge admiration for those with a real vocation.

For a privileged man like Leo to seem to lay the blame for the problems of the health service at the door of these people, who do so much for other people's families, wanting to spend time with their own families, struck a bum note.

The thing is that Varadkar probably had a point. But his beef is not with the staff themselves, but with the people who manage the resources.

And perhaps he should have presented the holiday issue not as the sole cause of January mayhem, but as one factor of many that could be looked at by management.

Maybe what Leo needed on this one was just a slightly better bedside manner.

Sunday Independent

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