Heart Beat: The waiting game is no longer an option. The election is upon us. Hold onto your hats, you will be dizzy from all the spin.
There are interesting times ahead. Cicero wrote in De Legibus Salus populi suprema est lex (The good of the people is the main law) and us collection of ingrates have to be reminded of this. Trouble here is with perception and the good of the people apparently does not apply to all the people. The rhetoric is there and we are all going to become active citizens. Accordingly, we are not to look to the State for everything. Just as well, I am thinking.
The Taoiseach says we are all to be concerned in everything that involves us, and that there is a feeling that we have become more materialistic, maybe even more selfish, and that many would conclude that for all our new wealth, we are much the poorer.
You won't find any of this in the Sermon in the Tent. There the chosen few are told that a rising tide lifts all boats. Aren't we the envy of Europe? There are a few malcontents out there who proclaim that a lot of our prosperity is built on sand and unsuitable foundations. Indeed, there are unfortunates out there as well who would claim that their new over-priced, under-serviced houses were also so built.
I am only a doctor and far from an economist but John Kenneth Galbraith wrote that the trouble with this "trickle down theory" is "the less than elegant metaphor that if one feeds the horse enough oats, some will pass through to the road for the sparrows". With great respect, your conversion here appears to be of the Damascene variety, welcome indeed if sustained.
Mary Davis and her distinguished group will do us all an immense favour if she can make people alert to their responsibilities as well as their perceived rights. No citizen should ever abdicate their rights and responsibilities to the State on the basis that big benevolent brother knows best.
All around us is the evidence that this is manifestly not the case. The founding father of the Taoiseach's party apparently had the facility that whenever he wanted to know what the Irish people wanted, he had only to look into his own heart and it told him what the Irish people wanted.
People must have been more credulous then. Michael McDowell appears to be the only politician with this kind of certainty around today. His only problem is that about 97 per cent of the population don't agree with him. This ridiculous posturing arouses not empathy, but rather contempt.
We've had the promises; we've had the reports, the experts and the expensive consultants. What we have now is the shambles that resulted from poor planning and little real achievement. Let us have active involved citizens to make this country what it should be. Let them make it caring, concerned and just. Let them make us mindful of our least fortunate. Let us have a country where health, housing and education are affordable and good quality. Let's have a State where the government is seen to be working and, above all, accountable.
These, fundamental as they may be, are matters general. Medicine, rather its problems, are not going to go away any time soon. In fact, these difficulties seem to be governed by some sort of mad geometric progression which sees them multiply, almost it would seem, by the hour. The latest brew - the problems in Monaghan and Roscommon regarding the local hospitals - has boiled over.
Why are the people of Monaghan to lose their acute hospital services while Roscommon is granted a reprieve? This has nothing to do with politics, you understand. Prof Drumm says he will not be diverted from the proper course of action by pressure groups, political or otherwise. The Minister for Trolleys says it's Prof Drumm's problem, but there was some mistake about Roscommon. This brings me back to my original question. What is the difference between the two hospitals?
Prof Drumm knows you cannot deliver modern medicine in small inappropriate locations. He also should know that simply to abolish services before credible alternatives are in place is unacceptable. Let the people see the state-of-the-art hospitals in these localities built and operating before we shut what we have. We should not shut them at all but adapt them to provide services that do not require the intensity of the regional and tertiary hospitals.
Let's have a modern ambulance fleet including an air ambulance facility and trained crew. Let's have quick access in times of trouble and let us be sure that beds are there for emergencies.
To tell the staff in Cavan hospital that they must accept referral from Monaghan whatever their own circumstances is wrong. To threaten non-compliant doctors with reporting to the Medical Council is unreal. Doctors should provide care only when it is safe to do so and they are the best judges of that. Woe betides the medical profession if they lose their independence and come under political control. Woe betides the patients if this comes to pass.
Meanwhile, as trolley numbers start to rise again, not only in the four or five Dublin hospitals that are usually quoted; I pose for Prof Drumm and the Minister one final question. How is it that while closing these small, so-called inefficient hospitals which lack a critical mass of patients, you can stand idly by while similar sized private hospitals spring up all around you?
Maurice Neligan is a heart surgeon.