Heart Beat:As I write, the nurses dispute is still with us and escalating. Far from talking the language of moderation and conciliation, the employers are talking the language of strife and war.
The nurses have signified willingness to talk and to discuss issues of productivity, rostering, skill mixes and have intimated readiness to consider anything that will improve the lot of the patient. They see little understanding, let alone accommodation, across the table.
We are talking negotiation. A set of demands are made and there is a counter offer in response. Gradually the two sides move closer, often facilitated by mediation, a settlement is agreed and the world moves on. In this case, one side appears reluctant to move in any significant way.
The Minister and HSE tell us that they are looking after the patients and the taxpayers and are mindful of the effect of knock-on claims throughout the public service. Whatever about the third point, the first two are laughable, considering the chaos in the public health service, worsening by the day, and the crass waste of resources exemplified by PPARS and the waste of moneys already expended on the Mater site.
Whatever the Minister and HSE may choose to believe, public support is with the nurses and there is also much support within the Dáil on all sides of the house.
However, there is form here. The nurse daily trolley count over these past few shameful years has been consistently higher than that of the HSE. They have not been prepared to play "hide the trolleys" or rush the patients through A&E departments solely to massage the figures. They have held to the ethics of their profession and put the patient first. They know, like the doctors, that their first ethical responsibility is to the patients, not to a corporate loyalty that would seek to gag their concerns.
It is indeed ironic that those who would seek to so gag them are introducing a "whistle blower's" charter, where doctors and nurses can complain about each other, but not about the dysfunctional system in which they work.
Increasingly however, they are not. On the one hand we have the Minister for Trolleys and her multitudinous colleagues in the HSE and Department of Health. On the other, we have the carers, doctors, nurses and paramedics, etc who try to make the increasingly dysfunctional system work.
The involvement of the latter groups in advising and planning the delivery of the service has been negligible. Such tasks are for those who, wearing shiny new, expensive hats, created the problem in the first instance.
It is much worse than that. At the height of the dispute we are told that it is the Minister and the brave functionaries of the HSE who care about the patients and the delivery of the service and are struggling to hold it together. By extension, presumably the nurses don't.
Let me disabuse them right now. They are not directly involved in patient care, which strangely enough involves far more than just answering the phone, other than to make the job of the carers easier and hence improve the lot of the patients. Their role should be enablement and facilitation, not endless confrontation. Could any reader imagine this hard line with power workers, guards, teachers, transport workers? Dock their pay, put their mortgages under threat; let them see we mean business!
The consequential poisoning of relations into the foreseeable future and the industrial relations minefield thus created, appear not to bother these bold warriors one little bit.
As I have said repeatedly, and as I heard Deputy Liz McManus say, this Minister is at loggerheads not only with the nurses, but with the consultants, the GPs, NCHDs, the paramedics, the dental profession and the members of the Impact trade union working in the health sector. Presumably these are the "vested interests" that the brave Minister has resolutely faced. I don't care if the Minister and those unknowing folk who agree with her live in their own little fantasy world. But in fact those "vested interests" comprise the whole health service - that service that she is supposed to lead and motivate. What chance of that now?
Ms McManus also pointed out, as many have before, the fallacious or, worse, mendacious premise behind the woolly concept of co-located hospitals. That is that every single one of us is entitled to a bed in a public hospital. This is an effort to drive insured patients into these ill-defined, hypothetical entities and establish irrevocably, but by stealth, a two-tier system in which neither tier will flourish. In reduplication, concentration of expertise, economies of scale and a host of other problems this daft, developer-led concept will create enormous problems. The crocodile tears for the public sector will not hide the fact that it is this segment that will invariably suffer most.
We have only 4,000,000, people. They have been totally failed in healthcare delivery as our prosperity has been squandered on every side. The absurdities and contradictions are countless and increasing. It is time to demand a real health service.
Maurice Neligan is a cardiac surgeon.