We must dream to escape nightmare; Statistics show that our beleaguered health system is the sick man of Europe


As published in The Sunday Independent on 27th October 2013

FRIENDS I have a dream today. I have a dream of an Irish health service where every woman, every man and every child could see the same doctor in the same hospital or clinic following the same reasonable wait if they have the same illness, regardless of their financial circumstances. The reality today is that we have a service where 40 per cent have “okay” care delivered in a timely fashion and 60 per cent have care that is mediocre at best and always tardy.

I have a dream today. I have a dream of a health system where every working citizen pays the same percentage of their income for the same health insurance benefits, where as a result the rich subsidise the poor, and where the unwaged are looked after by a caring society.

I have a dream today. I have a dream where a system of mostly not-forprofit insurance companies compete with one another and with the for-profit sector for the loyalty and custom of their members, using the weapons of service and efficiency — not the bondsmen’s whips of compulsion and administrative diktat.

I have a dream today.

I have a dream of a republic which has the same number of doctors per head of population as other modern European social democracies, not one where a handful of oppressive bureaucrats in cahoots with rapidly rotating gormless politicians insist that we should be forever at the bottom of the league table for every speciality in medicine.

I have a dream today.

I have a dream of a network of mostly not-for-profit hospitals and clinics, owned by a rainbow of charities, voluntary organisations, universities and municipalities, institutions which are obliged and incentivised to accept every citizen who presents to their doors needing care regardless of their financial circumstances.

I have a dream of a diverse medical profession where doctors have rational, locally negotiated contracts that reflect diverse working circumstances, needs and environments; where they are allowed to do research if they wish, where they may set up in independent practice if they wish, but where all MUST accept the insurance of any citizen regardless of class, race or wealth, and one where they must care for all in the same facility with the same waiting time and with the same personal commitment to their health.

I have a dream today. I have a dream of a medical education system which matches the number of doctors to the needs of society, where it is acknowledged that interns, senior house officers, registrars and specialist registrars are all trainees, whose positions exist to provide education not to extract a service. I have a dream of a system where all patients see a fully trained general practitioner or hospital specialist if they need care, not one where they or their families are looked after by trainee doctors.

I have a dream of a health system where an institution like St James’s Hospital, the largest acute hospital in our Republic — a fine institution which provides a great local service to some of the most socially disadvantaged people in our capital and which is also a national referral service for many diseases — does not find itself wondering which services to cut when its arbitrarily predetermined budget falls short in October.

I have a dream of a society which understands that it is neither moral nor smart to make hearing impaired children wait years before they can be assessed, years which they spend not hearing their teachers, years spent falling behind in class.

I have a dream of a society that is outraged that children who are unfortunate enough to have spinal curvature have to wait so long for corrective surgery that their deformity is 15 per cent greater than in neighbouring countries, resulting in more complicated management.

I have a dream of a government that understands that spending the same amount per annum on cancer drugs that we spent every three weeks in bailing out one bank is not spending too much money on cancer drugs.

Friends, I know my dream would cost money.

It would cost a little more than we currently spend but it would give us a more humane, more efficient health service and one that we could be proud of.

I fear we may not get there any time soon, but we must keep the dream alive and we must work to see it come to pass. I woke up and the dream was a reality. Sadly, it was a reality in Germany, not in our beloved Republic.

2 Responses to “We must dream to escape nightmare; Statistics show that our beleaguered health system is the sick man of Europe”
  1. John Ryan says:

    May an equally enlightened Taoiseach soon appoint you as Minister for Health. Where we might find one I do NOT know. A new political party based on your philosophy of care would be wonderful. I really appreciate your efforts at restoring decency and caring, rather than profit and indifference to our terminally ill Health Service.
    John Ryan

  2. John Ryan says:

    Maybe the Trainee Doctors should have their rather grandiose and often misunderstood titles removed. A mechanic is called a (whatever) year apprentice, so why not a doctor, Then we would all know who was attempting to treat us. Different colour name badges could be used reading from Green for a Consultant down to Red for Danger for a junior houseman. This would be so simple to implement and offer much more clarity. Not to mention patient safety, that is if that really matters at all nowadays.

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