Let’s reclaim our health service from politicians and private clinics

A CIVILISED society should have a good health service, able to make its sick people better and to treat them with respect and dignity.

That’s why I’ve never begrudged whatever proportion of my PAYE goes into our health service.

Over the years I’ve had a lot of professional experience of the dedicated people who manage the system, and they are totally committed to the health and wellbeing of the people of Ireland.

I’ve no fault to find with them, though I have huge sympathy with the size of their task.

And in addition, throughout my adult life, I’ve invested year after year in maintaining my status as a VHI subscriber. That, too, I’ve always regarded as a good investment — not because I’m interested in jumping queues, because I’m not, but because it’s another way of contributing to the development of a health service that really works hard for all of us.

In my innocence, I’ve always assumed that because we have made, and are making, this investment, we have created a working safety net. If you’re sick, you can turn to the health service. They’ll make you better.

And the VHI will help in that process. Together, the health service and the insurance will function as a sort of one-stop shop — you place yourself in their hands, and a team will click into place to sort you out.

The irony in all this is that I’ve never personally needed either the health service, or my VHI membership, until now. I’ve watched and supported others who needed access to care, and my family as a whole has had plenty of reason to be grateful to both the availability of a national care system and the VHI.

But, until a month ago, I had no personal reason to question what is going on within the system. Now I have a question I want to ask, and it’s this: what in God’s name is going on?

Let me explain. You may remember I moaned a few weeks ago about a back pain. Well, it never went away.

In fact, it got worse to the point where my local GP, who had put up with me manfully for long enough, decided I needed tests. And here’s where I made my first discovery. There’s nowhere you can go for tests.

Well, that’s not entirely true. If you’ve buckets of cash or loads of insurance, or don’t believe in the national health system anyway, you can probably ring one of the super-duper private clinics on the south side of Dublin (a bit tough if you live anywhere else, of course) and book yourself in. But if you just want to go into a hospital, owned and paid for out of your taxes, you can’t. You can’t go in the front door of a hospital and ask to be admitted — that’s just for visitors.

If you think you might be sick, but neither you nor your doctor can be sure, there’s only one way in — through Accident and Emergency. So your doctor gives you a letter (it’s like the first day at school), and you go to the A&E department of, in my case, a leading teaching hospital.

And there you take your place with people who are wounded or bleeding and clearly in a worse way than you are yourself, and hope to God someone notices you.

I was lucky, or maybe I picked a quiet day. Within eight hours I had been seen first by a nurse, then a doctor, then another nurse to take lots of blood out of my arm, then the doctor again to conduct (in a very charming way) a variety of unpleasant examinations, then a series of X-rays, then more discussion with the doctor in charge.

Within the eight hours there was a lot of waiting time, so I explored the hospital. Half of it is old, half new, but it is well designed and laid out. It’s particularly well signposted. At every corner you can find directions to almost anywhere within, and to almost any function.

Except one, I discovered. There’s no signpost anywhere to the chief executive’s office, although I’d be ready to bet that such a large organisation as a modern teaching hospital couldn’t function without one.

When, overcome by curiosity, I asked at one of the reception desks where the CEO’s office was, I was politely asked “why do you need to know that”?

Anyway, all the blood tests, X-rays and physical examinations proved one thing — I needed some more tests. That’s when the system really began to test my sanity.

The doctor with whom I had dealt throughout the day explained to me that I would need, ideally, a CT scan and an MRI scan.

If I was in an immediate life-threatening situation, that could be arranged within the hospital, but since I wasn’t, and especially since I was a VHI subscriber, it couldn’t. At least not without a delay of months (unless in the meantime I descended into a life-threatening situation, of course).

In the meantime I’d be doing everyone a favour by using my VHI to purchase the additional tests elsewhere — namely, in the super-duper private clinics I hadn’t wanted to go to in the first place. But I went to them — yes, to two of them. That’s because it turned out, when I went looking for appointments, that my VHI would cover a CT scan in one of the clinics, but not an MRI; and an MRI in the other clinic, but not a CT. (If you can follow all this, you’re probably not sick enough to need the tests in the first place!).

BEAUTIFUL places, both clinics, and lovely staff, and all the tests completed in a few days. The good news is that, ultimately, the tests revealed that there’s no specific reason I shouldn’t be still writing this column in 30 years’ time (at least, dear editor, I hope that’s good news).

The other good news is that we have a health system that is staffed from top to bottom by good and professional people who treated me exceptionally well and courteously.

But why isn’t it possible to go to one place — preferably a place we (the taxpayers) own and have built — to get your tests and to get better? Nobody will give you a reason — it’s just the way it is.

The truth, though, is that political decisions of the past few years, presided over by our current Taoiseach and Health Minister Mary Harney have been geared to ensuring that the drift is towards “competition” (although it’s so artificial, it’s unreal) and the free market in health.

Right now, the whole thing is about the public sector existing to enable the private sector to be as profitable as possible. And the key mechanism for ensuring profitability is to offer people the choice between waiting in pain or paying (over and above their taxes) for relief.

That’s not what its managers want — it’s what the politicians want. And a health service that is increasingly geared towards the generation of profit for some of the players is not our health service anymore. It’s about time we took it back.