Heads that won't roll

Heart Beat: "Who would write, who had anything better to do" - Byron

Heart Beat:"Who would write, who had anything better to do" - Byron

Yes indeed; but once you have started, it is sometimes difficult to stop. Like in the old days of writing examination papers when the invigilator prised the paper from under your still moving pen, conveying, as you hoped into the mind of the examiner, the impression that you still possessed vast as yet unrevealed stores of knowledge on the subject in question.

Now it's some curmudgeonly editor who cheerfully carves chunks away. Rather like a surgeon I suppose.

Like almost everybody else I was saddened and appalled by the cancer service debacle and the insensitive way the patients were treated. This is quite apart from issues of diagnosis.

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Prof Tom Keane, who is to organise a new approach to the provision of such services, has rightly pointed out already, that false negative and false positive results in imaging and pathological diagnosis are a universal problem. The aim is to do the best possible and to reach internationally accepted norms.

He needs more than everybody's good wishes in his task. He needs the funding for equipment and staffing and building. He does not need political interference.

There was something else fundamentally wrong here. That was the seeming ignorance, or worse indifference, to the matter of patient confidentiality. This is a cornerstone of the doctor-patient relationship. The patient may waive such confidentiality and may well do so to draw attention to failures in the service and their consequence. The doctor can never violate this principle save with the patient's permission.

Lest I appear abstruse here, let me ask whose idea it was that left these patients and their support to run the gauntlet of the assembled press as they made their way to their recall appointments, whose time and place had been widely broadcast? This was a callous and a stupid thing to do.

We are told now that the person involved reacted quickly and decisively to the problem. Such reaction was careless and unthinking.

Quite simply as the need for recall arose, the relevant GP should have been informed, the patient reassured and counselled as to the problem, and the likelihood that all would be well, but that further tests would be needed to ensure this. They would then have been expeditiously referred for such.

The patient's privacy would have been fully respected and many would have had their checks long before they did, time being a most valuable weapon in cancer treatment. There would have been no need for a dramatic flying squad intervention, efficient and humane as it undoubtedly was.

Instead somebody decided these unfortunate patients had to be grouped into a "cohort".

As usual nobody walks the plank. The HSE board, those mysterious gurus, are to set up a committee to inquire how to set up an inquiry as to what should be done, and find an independent individual to inquire into the fault line so convincingly demonstrated; more procrastination, more delay, little progress.

In tabloid football parlance, the Minister tells us that she is not going to walk off the pitch. You're right there Minister, your mates will make sure, putting team before country, that you stay there, even if your achievements seem to consist largely of own goals. That you might queer the pitch for years does not occur to them.

Staying with the football idiom; I'm not exactly over the moon about that. In setting out your stall, as you so engagingly put it; you listed among your achievements: putting in place a lay majority on the Medical Council. Other countries were now following, you said. God Almighty, what a priority, what an achievement!

Would you explain to the bewildered populace how this could help cancer patients or those marooned on trolleys or those whose carers and support services have been with- drawn as a result of your policies? But then a lot of that isn't happening or is exaggerated.

After all, didn't you tell us that a friend of yours said that spending time on a trolley wasn't all that bad? You also told us that you brought in a redress board for the victims of Dr Michael Neary whose files disappeared and had nobody to vindicate their rights. You didn't tell us that many of the flaws uncovered by Judge Maureen Harding Clark in her review of that sorry episode remain today and the reforms the judge suggested have not been implemented.

Somebody else did it, I'm not to blame. Intimations, no more, that maybe things are not altogether well in the HSE, probably pave the way for some relatively junior person attached to this careering juggernaut to be pushed off.

Modern day tricoteuses waiting expectantly at the guillotine for heads to roll as a result of these latest debacles will be sorely disappointed. The blades just bounce off brass necks. I am amazed that continual attempts are still made to shoot the messenger. If the doctors or nurses point to problems, they are "vested interests". If Opposition politicians step forward, they are merely playing politics. Don't even mention the press - we all know they're against us.

Talleyrand wrote "Freedom of the press is a necessity of the day. A government exposes itself when it obstinately rejects what the day proclaims is necessary."

This Government continues to expose itself.

Maurice Neligan is a cardiac surgeon.