Time for opposition rethink on health?

There’s been an understandable amount of outrage at the case of seven women who were misdiagnosed as being clear of cancer. But Stephen Collins in the Irish Times on Saturday argued that the opposition is doing the voters a disservice by obscuring the issue beyond the headlines.

In fact in policy terms Harney and the Health Service Executive have been fighting a ferocious battle against an array of forces to try and close small and outdated cancer treatment centres to provide vastly improved treatment at a smaller number of centres of excellence.

That policy does entail serious problems for people living in remote areas but, while that is something that has not yet been addressed properly, it is another issue. The Taoiseach lost his cool in the face of the goading he endured in the Dáil and that expression of frayed nerves generated a further day of headline news.

The Opposition may well have scored in the purely political objective of damaging the Government but, in the process, the options facing the country in terms of providing the best type of cancer treatment for the Irish people have been hopelessly obscured.

And it’s not new:

One of the most unfair political campaigns ever waged was that which destroyed the political credibility of Fine Gael’s Michael Noonan, when he was minister for health in the rainbow government. Noonan was savaged by Fianna Fáil and the PDs over the hepatitis C controversy and politically he never recovered. Nobody remembers now that the compensation scheme he introduced for women infected with the hepatitis C virus was the most generous of its kind in the world.

All that is remembered is that, goaded by the current parties of government and influential people in the legal profession, he uttered intemperate remarks about some of those campaigning against him.

At base, the struggle to create a functioning national health service under the HSE has suffered from the excessive parochialism of the Republic’s party political system. Kathy Sheridan writes (subs needed):

Back in 1995, a young Prof Hollywood, newly-appointed Marie Curie professor of clinical oncology at Trinity College Dublin and consultant oncologist to St Luke’s Hospital, Dublin, festooned with distinguished awards and fresh from the Baylor College of Medicine in Houston, Texas, was already stressing his belief that spreading the cancer services among a small number of small centres would dilute existing expertise and resources. Unlike many of the players involved, he had no vested interest when, as regional director of cancer services for the Midland Health Board, he chose Tullamore as the Midlands Cancer Centre. “Tullamore made sense,” he says now.

Taking Longford and Westmeath catchments into consideration, Tullamore was the obvious geographical choice. He had the full support of the CEO of the Midland Health Board, and of senior management. Others, however, had a more partisan agenda. “Clinicians and board members would argue that the choice of Tullamore would lead to the downgrading of their particular hospital, and that was more important to them than the development of cancer services,” he says in his customary cautious manner.

There was nothing civilised about many of these “discussions”. One board member recalls that after a public meeting in the Killeshin hotel in Portlaoise, Prof Hollywood needed a police escort to his car. Another remembers an attempt to remove him from the medical board in Portlaoise hospital. Despite his position, qualifications and international recognition, local politicians challenged his capacity to advise anyone on the development of cancer services. The view “what we have, we hold” held sway. “What was there,” recalls a health board member, “was a small breast cancer unit with one surgeon with an interest in breast cancer, no triple assessment, no dedicated pathology services and very limited radiology services. I’ve noticed around the country that medics themselves, when they or their families are in trouble, will studiously avoid small units and head straight for the large teaching hospitals.”

Collins argues it may be time for Tallaght Strategy on health:

The lesson from Fianna Fáil’s ruthlessly aggressive and partisan opposition between 1995 and 1997 is that putting the common good first doesn’t pay.

However, the Opposition parties should consider whether it might even be in their own long-term interest to help get health service reform moving in the right direction over the next few years. After all, their obsessive emphasis on health did not win them the recent election.

In any case there are a range of other issues which the Opposition could exploit to expose Government arrogance and ineptitude. [emphasis added]

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  • Turgon

    This case is extremely distressing. It does highlight an inherent contradiction in the way we tend to view health not just in Northern Ireland, RoI or even GB.

    Essentially people want hospitals very close to where they live. However, they want these near at hand hospitals to offer all the services which a large central hospital offers. Herein lies the problem. Medicine today is extremely complex. Different doctors and nurses look after different specialities and as such need to work in large teams to provide the best possible care for patients who often have multiple problems. Hence, the small local hospital has an enormous problem. It cannot offer all it feels it should yet the public are demanding it be kept open.

    Sadly confromting this problem is something which politicans, civil servants and sometimes even doctors throughout the UK and RoI (and I am sure elsewhere) are not willing to address.