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Were we conned again by the trolley watch show?


Sticking plaster: Simon Harris has put more resources in place to try to address the trolley crisis Photo: Caroline Quinn

Sticking plaster: Simon Harris has put more resources in place to try to address the trolley crisis Photo: Caroline Quinn

Sticking plaster: Simon Harris has put more resources in place to try to address the trolley crisis Photo: Caroline Quinn

There is no doubt that the annual trolley crisis is deeply distressing for all those involved, but it's hard not to be a bit cynical about what is now a tried and tested part of the Christmas and New Year TV and radio schedules.

This year, however, there was reason to think it might be different. It started the same way it usually does. We reached peak trolley watch, a service brought to us courtesy of Liam Doran and the INMO. And then the poor sucker who currently occupies the Ministry for Angola was duly dragged out to make the usual mea culpa noises and to promise swift action.

The usual second act of this is that some groups in the health service get some concessions, more resources are handed over, budget committed, and then the situation calms down, and hospitals go back to operating at 90pc of capacity for the rest of the year.

But this year there was a suggestion it might be different. The minister, Simon Harris, being young, new and idealistic, was making very reasonable noises, suggesting actually it wasn't all his fault, it wasn't all down to a lack of resources, and that there were many people responsible for managing these situations and that he would be having words with them.

Indeed, he seemed to say in a letter to the head of the HSE last Thursday that sanctions should be taken against those who weren't doing their jobs properly. Perhaps it said all we needed to know about the health service that the Irish Independent seemed to know the contents of this letter by Wednesday night, but the head of the HSE still hadn't seen it by the time he appeared on Today with Sean O'Rourke after noon on Thursday.

A Rocky-style air of excitement built around the young minister on Thursday with his Government colleague Shane Ross suggesting Harris was going to kick ass at a meeting with the HSE. But one man kicking ass was not going to throw out the choreography of this annual event, which is set in stone at this stage.

We heard a bit from disgruntled patients for sure. And some of their stories would kill you. A man with brain cancer was waiting in what must have been a Petri dish of germs in A&E in Cork. Older people were casually robbed of their dignity. It was the usual horror show.

But in general, the airwaves at this time are mainly filled with health professionals, all people with agendas, all people with skin in this game, but all treated as if they were impartial bystanders or perhaps even advocates for patients. While there is no doubt that many health professionals are great advocates for patients, they are, by now, masterful at presenting themselves as being solely that, as having no agenda of their own whatsoever.

So the narrative on the airwaves over Wednesday night and Thursday was overwhelmingly driven by health professionals. Many of them are no doubt very good people who are fighting a system that is broken, but the narrative they presented was quite specific.

Firstly they are all working incredibly hard, to a superhuman, heroic level, to fix this situation. Indeed, a standard comparison now seems to be to compare an overcrowded A&E in a well-equipped First World hospital in an Irish city with a war zone.

Chaos was another word that was used a lot. Which is a worrying word when you are dealing with medical matters. We have all at some stage worked in situations where there is extreme pressure and we know that chaos is not a good outcome. Most of us are lucky enough not to have to deal with life and death the way health professionals do, but we know that if you allow things to degenerate into chaos that's when things go seriously wrong. But it seemed almost like a boast last week that things were chaotic.

Which would tend to lead you to the next question. Why is the situation, however overwhelming, not being managed by someone so that it doesn't collapse into chaos? And the answer to that was given very clearly, too, again by health professionals. Hospital managers and department managers made it very clear. It was not their fault. It was out of their control. They were backed up on this by their bosses. The head of the HSE went on the radio to say the chaos was outside his managers' control and this was not the time to ask questions or talk about sanctioning people who can't do their jobs.

Whatever about managers, there is no doubting the heroism of doctors and nurses in all this. We all know how they are the ones who make most outcomes from the health service good ones. They are also the ones who manage to inject a bit of humanity in the most appalling circumstances. But equally they are only human beings and it would be sentimentalising them and demeaning them to suggest they do not have their own agendas here to do with pay and conditions and whatnot. They are not saints, and it would be unfair to expect them to be.

But the narrative from smooth-talking medics has been overwhelmingly to portray doctors and nurses as the only good guys here, the ones holding off the chaos, the ones working long hours without being paid, the ones who are all on the verge of burnout. It was a very clear message. The health service needs more resources and we need to treat existing staff better.

As we came towards the weekend, more resources were being put in place. Because when you have neither short-term tactics, nor a long-term strategy, you grab at whatever easy solution is in the wind. And there was no arguing with the choreography, no arguing with the dominant narrative. Everyone here was doing their job and more, this was nobody's fault. The Government just needed to give more money.

But ultimately you can't help but feel that the vested interests in the HSE and the health sector made far better use of this crisis than the minister did. INMO general secretary Doran nearly gave the whole game away on Friday. As more beds were opened and resources committed and peak trolley watch abated, Doran, whose organisation, remember, is the source of trolley watch in the first place, said: "My members have had enough, we have a 90pc mandate. We are starting discussions next week. The clock is ticking. Their patience is worn out and I cannot rule out industrial action in February, not in the context of money, but in the context of the environment and conditions and the deplorable staffing levels that exist. They're not going to make do any longer for the sake of patients and in the interest of their own health and well-being."

And you couldn't help but think, is that what all this was really about?

The other reality is that all these sticking plasters are choices between scarce resources. However daft you think giving free GP care to the children of millionaires is, it seems now that not only was the liberal use of free GP services part of this problem, but its continued roll-out will be affected now because of resources used on this occasion. As will elective surgery for the next few months.

We can keep throwing resources at the dog that barks the loudest at any one time, without being allowed to examine how chaos may have developed. But any good doctor will tell you that just treating symptoms as they arise is not a good health policy.

Sunday Independent