Heartbeat:Is it safe to come out yet? Has the mini Rottweiler gone away? No, I am not going out of my mind. I will explain.
Easter Sunday morning on a beautiful day, I was in Glenbeigh, Co Kerry and I went to buy the Sunday newspapers. "I see you are in the news yourself," said Maura, the shopkeeper. "What about, this time?" I asked. She produced the paper and sure enough there I was, large as life, front page, beside an even more dramatic feature on "Bertiegate".
"Minihan slams medic Neligan over nurses," the headline proclaimed. Now, I know who I am, so no problem there, but I was genuinely puzzled about who Minihan was, and how come he was so bent out of shape. I bought the paper and slunk away to find out why I was being "slammed".
Apparently the gentleman in question was incensed by my support for the nurses in the current dispute, and in particular by my suggestion that the Taoiseach might bring his undoubted and pragmatic skills as a negotiator, to bear in the present impasse.
It being Easter Sunday, he then resurrected material he felt to be to my detriment, to cast doubt on the propriety of my daring to comment on the subject at all. There was no reasoning I could detect in his diatribe; it was basically good old fashioned mud slinging. Having read it I couldn't even manage a solitary quake in my shoes. Denis Healy's famous riposte to criticism from Geoffrey Howe, came to mind: "It was like being savaged by a dead sheep."
Having ascertained that Senator John Minihan is a Progressive Democrat, things became clearer still. He is the second PD activist to attack me openly in the past few weeks, for apparently repeatedly writing what everybody knows in any case - that the health services are in total disarray. If they choose to believe that everything in the garden is rosy, that is their prerogative, but I think they may find, in the near future, that such belief is not widely held. As for myself, with a lifetime in medical service in this country, I shall continue to express my opinions without fear or favour.
Later on that Sunday, I talked at length to a senior nursing sister with 33 years experience in a major Dublin hospital. She also possessed a higher nursing qualification. She told me indignantly, that her salary came nowhere near the €56,000 that is being represented as average nursing pay. I have heard this repeatedly over the last few days, from nurses from all over the country. One can only presume then that this canard has been deliberately circulated to damage the nurses' case.
If so, this is truly shocking. If this is not the case, can we then have an explanation as to where the figure comes from?
I cannot help thinking that if such a dispute were to involve transport, power supply or other public utilities, there would be far greater urgency about finding a solution. Most nurses are not militant by nature and most are female in this caring, nurturing profession. Does that mean it's alright to push them around then?
Contrast their situation with the speed with which the Government moved to appoint a chairman of a new Stardust inquiry, when faced with picketing and political unrest. A bit of common sense is required here, sooner rather than later. There can be no victories, only compromises, brought about by persons of goodwill. Talk of docking pay and other sanctions, like ending flexible working, are seen as threats and only further harden attitudes. I believe there to be goodwill and flexibility on the nursing side. Let us see it quickly reciprocated by the employers. There is no shame in compromise.
Controversy has arisen in the US over the role and responsibilities of small hospitals that do not provide full services and emergency cover. This is germane to the situation that is developing in a haphazard and unregulated fashion here. The issue arose when it was realised that some of these small hospitals simply dialled 911 (999 here) when emergencies occurred and thus had the patients transferred to full service hospitals.
In two recent cases, the patients being transferred died. This led to intense criticism and allegations that in such limited facilities, decision making is more likely to be driven by financial rather than by patient interest. Consequently, demands are being made that hospitals must have emergency provision in place and that any limitations in service must be disclosed to patients.
We have no formal requirements as to staffing and delivery of care. It is very important that such are established without delay, and that compliance with such standards should be mandatory, before any such institution could be registered and certified to deliver patient care. Such certification can be graded, allowing various categories of hospitals delivering different levels of care.
Given the fact that emergency situations arise, even in the treatment of seemingly innocuous conditions, arrangements must be in place to allow the transfer of such patients to a higher grade hospital capable of dealing with the situation. Simply ringing around begging for a bed, is as we have seen, is simply not an option.
Before we get near such concepts as co- location and further hospital development, ground rules and regulations must be established. We are putting the cart before the horse.
Maurice Neligan is a cardiac surgeon