Don’t go off your trolley over a reshuffle of health bureaucrats

THE NEW plan which Health Minister Micheál Martin has apparently presented to his cabinet colleagues will, reportedly, have as revolutionary an effect on our health service as the invention of the trolley did.

Without the trolley the system would have collapsed years ago because there would have been no place to park patients as they waited for hours on end - if not days - for crucial treatment.

Uncomfortable though the trollies are, they are a vehicle, so to speak, for advancing from a corridor to a hospital bed and to eventual relief.

The new reforms being proposed by Minister Martin seem to offer a panacea for the health system, rather like a Fianna Fáil election manifesto with, or without, secret cutbacks.

Like the latter, we will have to wait and see what transpires between the proposals and what actually is implemented.

At the moment, something like 9 billion is being poured into the health system and the service still remains in an abysmal and deplorable state which, it is generally acknowledged, is not the fault of the medical personnel who try to make it work.

So, obviously, money is not the problem but rather how it’s spent or, more appropriately, misspent.

That is a problem which Micheál Martin seems about to tackle with his new plan, but which, it must be said, prompts some scepticism.

So far, and admittedly everything hasn’t been spelt out yet, the message coming from the Minister’s direction is that everything will be “slimmed down.”

The Department of Health will be “slimmed down” and so will the health board system.

Four regional health service executive bodies will replace ten health boards and the Eastern Regional Health Authority.

As well, the total number of health agencies will be reduced significantly from 57 to about 35.

It beggars belief that we have so many such agencies anyway,

Now pardon me for mentioning it, but slimming down the Department of Health and the health boards sounds like a euphemism for merely transferring the flab somewhere else.

Anybody ensconced in a nice, comfortable, pensionable civil service or public service job is not going to be displaced by the Minister’s glossy new plan for the health service, no matter what his consultants have advised him to do.

Talking about gloss, and hopefully it won’t be, one of the proposals is for greater professional and “consumer” representation. I can’t help thinking that when suddenly a Minister starts talking about giving consideration to consumers, the very last thing the consumer is going to get is consideration.

Describing patients as “consumers” is a kind of Americanism aimed at trying to convince unfortunates who have to present themselves at accident and emergency departments, and who end up on trollies, that the system cares.

It is impossible for people lying on trollies, waiting interminably to be treated, to consider themselves as consumers. Similarly, people who are tired of being on ever-lengthening hospital lists are not consumers: they are victims of a grossly inadequate health system.

To describe them as consumers would be to imply that they have some rights, which they patently have not.

They are long-suffering casualties of a system which for decades has been creaking at the seams.

But even to bestow such a dubious description on patients, and to offer them representation, the Minister has a bit of clearing out to do in one department which is going to be met not just with opposition, but hostility.

He proposes to take local politicians out of the system, and to do that he will have a bitter fight on his hands because health board membership has given them a spurious claim to be able to work miracles in matters of health for constituents.

Getting rid of the health boards will, of course, remove one of their platforms but the Minister will, no doubt, be faced with demands to allocate places on the new structures to politicians.

The intention is that the “consumers” generally will have representatives - and they won’t be politicians.

The first salvoes against such a move are coming from within the minister’s own Fianna Fáil organisation, and no doubt cross-party support will inevitably follow. It usually does when the self-interest of politicians is under attack.

So, when the minister sets up the new four regional health service executive bodies to replace the health boards, and the proposed new national hospital agency, if he ever does, they will be politician-free zones.

We’ll just have to wait and see whether the Minister’s resolve will be sustained - or just what compromise will be arrived at.

On another unrelated subject, although it’s got nothing to do with Micheál Martin, it has got to do with health. At least the health of a 15-year old boy.

At this stage, the name Dolores Clover may mean nothing to you, but a couple of days ago she had her 15 minutes of fame when interviewed on television in Antigua.

She was absolutely ecstatic because her son had just sailed into the harbour, having left Tenerife 25 days previously.

Her 15-year old son, Sebastian, or Seb to his friends.

Personally, I think she should have been arrested and done for allowing, even encouraging, the young lad to embark on a lone journey at a treacherous time of the year across waters infested with killer whales.

Instead, she was feted by the international press as she basked in the reflected glory of a 15-year-old who had put his life at risk in order to become the youngest person to sail the Atlantic single-handed.

Not that her husband, Ian, was much better.

He is a professional sailing instructor, and they had challenged each other to a father-and-son race across the Atlantic.

Instead of telling the young fellow to cop onto himself, and offering to take him on at an egg-and-spoon race in the local park, or even a game of golf, the father agreed to the challenge.

Oh, yes, apart from being a professional sailing instructor, daddy also runs a video production company and he hopes to sell a documentary of his and his son’s video diaries to publicise and fund their next voyage. Sebastian set out from Tenerife on December 19 with, in his own words, “a shoebox full of books and tapes and a box of Quality Street for Christmas.”

He added: “But the best thing was the tinsel. Mum doesn’t like tinsel and we always have this argument about it at Christmas, so I was glad to be able to decorate my boat the way I wanted it.”

I got the impression that mum usually wins the Christmas argument about tinsel - and probably any other one.

Obviously, there is no shortage of bobs in the Clover family.

The young lad’s yacht, Reflection, is worth about stg£60,000, as is his father’s 32-foot boat, Xixia.

This is clearly a case of the parents having more money than sense.