HEARTBEAT:The best things in life are free? Not a hospital trolley, writes Maurice Neligan
"But money answereth all things" (Ecclesiastes 10-19)
IT'S ALL about money. I was very slow to realise that. We simply need more money for the health system.
But that poses a problem: where do we get it? We can try saving on an already inadequate spend, a bit like getting blood out of a stone, in medical metaphor. Consider closing a few hospitals and stopping a few services, maybe? But no, you're right, we've been doing that for ages and things are only getting worse.
How about increasing the money for the HSE and the Department of Health? Don't even start whining about black holes, good money after bad, etc - we've heard it all before.
We could consider increasing tax; that always goes down well with folks who imagine they'll never be sick. They're the same ones, by the way, who lead the charge when a doctor screws up or a hospital falls down.
No, you don't think that would run? Let's try again.
Did you ever hear of a little word called rationalisation? We could try in a small way by cutting out overheads such as bonuses, and trips to the Superbowl in the Government jet.
Yes, I know, it wasn't really for that, it was for a one-day course on how best to provide cancer and dental services. Gosh, weren't the rest of us slow learners?
It took us ages. In the same vein - and quietly - maybe somebody could unravel all the layers of administration and find out exactly what they do. Maybe we could do without a small proportion of them, about 60 to 70 per cent.
Maybe, though, rationalisation is a bit grandiose. Perhaps it's better if things actually don't make any sense and remain fuzzy around the edges. That way, it's hard to identify who is responsible for the latest calamity.
God forbid that anybody might be fired or have to resign. This is the Republic of Ireland; we don't do that kind of thing here. I'll bet you Little Ian wishes he was down here.
I'm not having much success filling the coffers, am I? How about reducing salaries for doctors, nurses, dentists and paramedics? Maybe we could filch a few bob from the pharmacists? We could reduce the working day.
I know the new contract says we're going to extend it but that's only for the consumption of the plebs. How could we do that without spending more? Get a grip, will you?
I'm still not doing very well. Maybe I should start "thinking outside the box".
Of course, I realise that this can only be done on "a level playing field, going forward, from this point in time". Maybe it's not just the patients who need the speech therapists. I'd like to borrow one from the HSE but I gather they've been abolished.
Let's have some practical suggestions. How about a charge for occupying a trolley, say €5 per hour? You could charge €2 for a chair and €1 for standing, or sitting on the floor.
I've thought this through. There would be a maximum trolley time of six hours, and after that your trolley would be clamped.
The fee for removing the clamp would be €50 and each additional hour thereafter would be at a rate of €10.
Use of the toilet would be €5, with €1 remitted if you scrubbed the floor or changed a lightbulb. There would, of course, be a €5 charge for somebody to mind your trolley while you are in the loo. Room service on the trolley would be €30 with an extra €1 if you want a glass of water. What do you mean a cup of tea? Do you think we're running a hotel? I nearly forgot, use of a bedpan would be €10.
The possibilities are endless. If you had family members in the A&E department with you they could be liable to a congestion charge and there would be a booking charge if you wanted visitors in the hospital.
You could even get a few of the walking wounded to sit huddled on the pavement outside the hospital with little paper cups shaking them at passers-by. They could have little placards saying: "Spare €1 for the ultrasound."
There are no limits to the money to be made - I told you it was easy.
• Maurice Neliganis a cardiac surgeon