Let's Express

IS WAR THE ANSWER TO HEALTH?

An RTE investigative team went undercover to find out the extent of the waiting lists for hospitals in this country and what is the condition of those forced to wait. The result was an hour long documentary shown last Tuesday 7th Feb.

Called "Living on the list," it showed that 545,147 people are on the "official" waiting list, as well as another previously undocumented 87,038 patients who have been given an appointment or who are in need of follow-up care. The Indo explains that, "The numbers in the queue for surgery have risen to 82,005 – an increase of nearly 1,000 in a month.The numbers waiting for more than 18 months have also worsened – increasing from 1,738 to 2,937. There are also more people on the outpatient waiting list to see a specialist – up from 437,558 last December to 445,701."

What stuns me is that the total population is a mere 4,500,000 of which 635,185 are awaiting some kind of treatment in a hospital. That's almost fifteen per cent of us!! I have a vague memory of waking one night back in '77 or '78 and my throat was suspiciously constricted. Perhaps it was a swelling but to this day I don't actually know what it was. I was, and still am, allergic to hospitals but I must have been sufficiently concerned to get up and drive directly to the only hospital I knew of in Cork.

Anyway, the first memory was that the place was locked up and in darkness. Persistent banging on the front door finally turned on a light. The watchmen was convinced to take me to a nurse who in turn called the matron. A substantial figure of authority breezed in and basically scolded me for calling at such a late hour. My throat got a cursory examination before the matron told the nurse there was no need to "waste a doctor's time." I was then verbally drop-kicked back out the front door and the locks clicked firmly into place. My point though is there were no queues. The out-patients department was closed yet treatment was available on demand if you needed it. There was no sense of panic or evidence of anyone rushing around like a headless chicken, (as is the case today). Instead there was an air of peace and tranquillity, of organization and flexible efficiency. 

Naturally I felt like a bit of a tit and this was compounded over breakfast later when my Mother called me a pansy. You see, in those days you just got on with things and didn't make a nuisance of yourself. Fast forward to the late nineties and my young son had a fall which necessitated a trip to the same hospital's out-patients department. It was around 9.00am on a dark winter's night but the scene that greeted us was truly shocking. Two burly uniformed security guys stood at the door to vet all those entering. Inside it was wall-to-wall groaning including everything from rough looking guys with blood spilling from wounds to drunken hysterical girls babbling loudly. My son's little head wound paled to insignificance by comparison. It took five hours before two small stitches and a bandage were applied and I was never so glad to get out of anywhere.

How the hell did the whole thing fall apart in a mere twenty years?  And today it is a further twenty years later and it has become even worse. That programme on TV was harrowing viewing, featuring as it did, small children in terrible pain at home awaiting a call for surgery. Meanwhile management at the HSE is closing operating theaters at short notice to save money. Outpatients are full to overflowing because whole wards upstairs are shut due to understaffing and that same understaffing is down to cut-backs and austerity. All the while, the Kings of the hospitals, the consultant specialists, are scoffing at an offer of €400,00 p.a. and have instead opted to sue the HSE for hundreds of millions. Junior doctors work savage hours for very little and the remaining nurses are considering going on strike.

We've had Michael Martin, Mary Harney, Fatso Reilly, Leo Varadkar and now Simon Harris all sitting atop this shit heap at one time or the other and every one of those Health Ministers made matters worse during their tenure. Brian Cowen famously christened the Health Ministry as "Angola," during the time of that country's civil war. In the course of that war the starving population actually welcomed a bullet from either faction to put them out of their misery.

As I sit considering the last forty years of our health service I can see only two major changes that took place in all of that time. One was the decision to go secular. That matron i mentioned earlier was a no-nonsense nun. The hospital vomiting bug would have been an impossibility in her time because people like her ran a tight ship. She didn't fluff about with grand terms like 'best practice.' If you had a real problem it got dealt with there and then and if you didn't, out you went with a flea in your ear.

But the biggest one for me is today's preoccupation with sickness.  In my day it was a preoccupation with living the life and illness was a rarity not to be considered unless you couldn't function at all. Aches, pains and colds and flu's were worked through as an annoyance rather than the main course of life itself. You saw your GP every eight or nine years to be on the safe side and your dentist got a visit when your mouth was in extreme pain. But today every ad and billboard is asking you to consider your health. Ten leading questions concerning the everyday human condition like drowsiness, aches and lack of concentration are mentioned with the legend, "If you have two or more of the above symptoms then call your GP." These are expensive ads from the Pharmaceutical Industry and they know what they are doing. In return for his fee, the GP will refer you to a hospital for tests and the explicit vested interest of the Pharma crowd is prescriptions for their lotions and potions after those tests. The admonishment to consider your health might be more correctly positioned as, "Think of our profits," because that is truly what it's all about. 

My guess is that the malaise of the health service is threefold. Firstly, about a half of those on waiting lists have no real need to be there. Secondly, austerity has led to dreadful management decisions that have cost lives. And thirdly, there is some overpaid and underworked lard sprinkled all over the service sucking it dry for little in return. We forget when we hear the pious tones of health spokespersons that the edifice is a "For-profit-operation." Pharmaceuticals, doctors themselves, the chemist shop and the dental surgery are in it for the money with a nod to other motivations. It's about money, not cures or pain and suffering as we naive populace like to think. 

I listened to a doctor online the other day who talks down and dirty about it all. He said that when an oncologist sees another real live cancer patient in front of him, his eyes light up. According to the Doc this is because the incentives from 'Big Pharma' to the oncologist can double his already bloated annual salary. Cancer is great news for this speciality for which a cancer cure would be a huge downer. If Mother Nature were growing a plant free all over the place that cured cancer after eating a single leaf, the poor oncologist might need to seek other employment and take a massive hit to his lifestyle and status. You can be damned sure that vested interests will never let that happen.

So the Health Service itself is the real sick one requiring €13bn a year of your money to offer a lousy service. Yet they are spending a fortune to convince you through the media that any need you have to make contact with them is all your fault. This puts the sicker of the two on the high moral ground where they wish to be. They are the virtuous ones and you are the sinner. So sit there for eighteen months in pain and wait for the much needed appointment to fall through your letter box and be grateful when it does. 

And I'll end with the memory of M*A*S*H on TV and how a military field hospital could function under fire and yet get their job done somehow. The series was based on experiences in just such a set-up during the Korean war and it is the complete opposite to our hospitals today where getting anything done is a monumental struggle. The question of course is, do we need another war to fix that?

 

 

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