HEART BEAT:Perhaps the HSE hasn't noticed the money has run out, writes MAURICE NELIGAN
“You spotted snakes with double tongue
Thorny hedgehogs, be not seen
Newts and blindworms do no wrong
Come not near our Fairy Queen”
– Shakespeare A Midsummer’s Night’s Dream
YOU WONDER how Shakespeare prophesied the unholy symbiosis between the HSE (lines 1-3) and the Minister (line 4). The HSE does the dirty work and face the opprobrium. The Minister stands at a remove and protests, “Nothing to do with me”.
We’re a bit big for fairy stories now, but nobody seems to have told the Minister and Prof Drumm. Their enthusiasm for the genre is undiminished and indeed positively uplifts the gullible. Who could not read the HSE National Service Plan 2010 and fail to be inspired? It is a fairy story in the classic mould, drawing inspiration from the Brothers Grimm. Fantasy pervades every page and you just know that there must be a happy ending.
We will have the best health service in the world in 20??. And then we can all live happily ever after. Mellifluous prose it is not, but rather, as John Dryden wrote in the preface to King Arthur, that “fairy kind of writing which depends only on the force of imagination”.
Prof Drumm enthused about the development of Primary Care Teams (PCTs), 400 by year’s end, and Primary Care Centres (PCCs), 47 in the same timeframe. In the best tradition of tales of faery it is quite hard to focus on these shifting evanescent dreams. As an aid to delving through to the grey old world beneath these visions, you must bear in mind that a PCC is bricks and mortar. It will have X-ray, ultrasound and loads of equipment, and will be bright, friendly and Green (I swear it). It will be inhabited by the team(s); doctors, nurses, physiotherapists, chiropodists, pharmacists, soothsayers and three card trick men drawn from the administrative ranks of the HSE.
No wonder that Prof Drumm tells us that by 2011 we will have best virtual primary care structures in the world. The word “virtual” is mine because as a mere earthling I feel I must remain in contact with the planet.
The dream is a good one and was first mooted in the Primary Care Strategy in 2001, when the money was plentiful. It is now 2010 and we are broke. Let me ask a straight question because the answer does not appear in this wonderful story. How many of these fully staffed, equipped and housed centres actually exist right now?
My GP friends, many of whom have no trouble with the concept, tell me fewer than 10. The HSE seems to be saying several hundred. This question is simply answered by the HSE supplying a list of those centres meeting the criteria above, that are working and actually seeing patients. I don’t want lists of those about to open or planned because I believe that in the present economic climate, few will come to fruition. Perhaps the HSE hasn’t noticed the money has run out? Charitably I say they may not have as otherwise they would hardly be looking for a 5 per cent pay increase for their overworked executives.
You might wonder what all the PCTs who haven’t built their nests yet are doing, and how they are coping. We are told that they are holding meetings; perhaps dancing around the thorn tree, or the more hardened might be indulging in a few pints and a chat and planning their new centres. The Minister has ideas about this and once more we hear the old PD rallying cry of “Tax Breaks Abú”. It fires the blood, doesn’t it?
The rallying cry to the half-assed concepts that brought us to the brink of bankruptcy is shamelessly peddled again. The evidence of its disastrous failure is all around, empty houses and apartments, superfluous hotels and office space, a plethora of dragon’s teeth private hospitals sewn into the barren fields of recession.
Doubtless we will hear some tripe about the crisis presenting an opportunity for cheap construction. Well, let me tell you something; a crisis is seldom an opportunity for the body politic. A crisis is what it says on the tin: a crisis. Forgoing further tax revenue and more borrowing is not what we need. If we have to wait until we are financially robust enough to move forward again, then we wait. We eliminate waste and useless mouths and we care for our patients as best we can.