It really is a question of priorities. As Chris Lyons, network chief of the HSE North Dublin, observed, ‘It takes a population of 200,000 to properly sustain a small hospital’ - as though a hospital were a medical fattening station, to be fed by the people living in its hinterland. In this topsy-turvy world, the patient exists to serve the hospital; and communities exist to provide the essential nutrients that medicine requires for its empires - the disorders and conditions that permit its specialties and sub-specialties to thrive.
Marie O’Connor, Emergency, Irish Hospitals in Crisis, 2007
Trying to get a handle on what’s going on in the health service I stumbled across Marie O’Connor’s book, Emergency, Irish Hospitals in Crisis. She is a journalist and a member of the anti-Hanly Health Services Action Group. The book provides a lot of food for thought , among the ideas explored are how the health system is run for the benefit of the medical profession rather than the people it is supposed to serve, the increased trend towards privatisation and market driven corporation solutions, and how the health service is less and less accountable to the democratic institutions of the state. It’s worth reading alone for the shocking insights into how maternity care works in this country.
She writes:
The Government’s plan to centralise our hospital services raises issues over the kind of society we are creating, and have created: the dominance of technocracy, the loss of social solidarity, the rise of a small, powerful, urban, academic, elite that has driven a particular agenda in medicine for forty years, or 400, resulting in a massive loss of equity for town and country alike. We now have a health system that actively discriminates against local communities, their hospitals and their staff. Consultants there (and elsewhere) practise a les prestigious, less careerist and more community-oriented form of medicine. There are different strands in medicine, different views; only one is in the ascendancy. Today, the untrammelled rise of the biomedical or technocratic model of health has all but snuffed out the flickering social model. With primary and community health systematically starved in recent decades, local communities are doubly in jeopardy.
Marie O’Connor, Emergency, Irish Hospitals in Crisis, 2007
Having a Health minister who is ‘closer to Boston than Berlin’ doesn’t fill me with confidence that this situation is going to change.