Things used to be simple

HEART BEAT: I am forever digressing into matters non medical but some of these at least for me can be therapeutic.

HEART BEAT: I am forever digressing into matters non medical but some of these at least for me can be therapeutic.

Thus it was while sitting at home the other evening; I noticed what I took to be a small well camouflaged bird on a feeder suspended from a tree branch. On closer inspection it turned out to be a mouse. We have seen the enterprising creature on several subsequent occasions.

In the same week one evening at dusk we saw three foxes together in the garden, (a skulk?). It was the first time we had entertained a family, although individuals were common enough. A set had actually been dug in the lawn at the end of the garden but we had felt it to be unoccupied.

This week we had two hedgehogs on the lawn and today for the first time we had a grey squirrel. I also found the eviscerated bodies of three frogs beside the pond; they reminded me of my dissecting room days. The culprit heron was long gone.

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I have spent the last few days competing unsuccessfully with every bird known to man for the remnants of my cherry crop.

I am not talking about Kerry, but Dublin, so if you hear about a safari park opening in Blackrock, you will understand that I am supplementing my state pension. For me such happenings are joyous, interesting, and yes, therapeutic.

It is not as if there is a shortage of medical matters to engage my pen. Firstly I am glad that Prof Drumm has accepted the crown of thorns that is the Health Service Executive. Hercules and the Augean stables spring to mind for some reason.

I wish him and his team well, and I hope that the politicians and the new breed of medical entrepreneurs will give him space to formulate and initiate his own policies. I won't write anything nasty about his endeavours for at least a week.

How about one simple thing for a start? I received a document entitled Developing the Health Service Executive - Transition Planning - Phase 2.

It deals with structures, pathways, corporate affairs etc., all the elaborate meaningless speak of bureaucracy run wild.

At the end of a section dealing with corporate affairs there is reference to a section covering "consumer affairs and complaints", this figures behind a section covering parliamentary affairs, the 'cover your ass group'.

The last group to tread the corridors of powers in Health dispensed with such a group as they figured the public were too dumb to notice. This of course is all mind numbingly interesting except for the "consumer" bit. Could this possibly refer to patients? I thought they were the whole reason and centre of a health service, a caring health service. In this context the word consumer is at best ill chosen, at worst offensive.

To judge by this document things are very different now than in my intern days. The hospital seemed to be run by a troika of powerful nuns, Rev Mother, Matron, and Sr M. Claude the bursar. There was also a medical board consisting of the four most senior physicians and the four senior surgeons.

We dealt with Sr Claude in matters of our pay and you in fact collected same from her office, you also received a homily cautioning against it's conversion into beer, or possibly worse being forfeit to the bookies.

It was a simple enough payroll; there was no such thing as overtime or hours in lieu. I well recall after the first stirrings of medical unrest, a deal was struck that promised some back pay for the denizens of the mines.

Trouble was that many of the peripatetic young doctors on whose behalf the deal was struck, had moved on. Sr Claude solved this problem entirely to her own satisfaction. She sent for one of the interns who was a Medical Missionary of Mary and asked her to contact her sisters and spread the good news. She told the young nun that there was no point in contacting the rest of us as we would only drink the money in any case.

So the hospital worked, everybody did their best. We were taught comprehensively and well; the only item missing then as now was money. Of course those feeling excluded, medical and other, grumbled incessantly and muttered against the powers that be, as is the way of the world. We mere worms did not even get to grumble other than in the most ill informed way, as also happens today.

But inevitably, "the fashion of the world passeth away" ( 1 Cor. ch.7 v. 31). Quite simply this quiet effective form of hospital governance came to an abrupt end.

The Medical Board were summoned to meet the Mother General of the Mercy Order thanked for their years in running the hospital then 'ite missa est'.

The structure of the hospital was fundamentally changed. We now had Financial Control, Administration and other weird conditions. Pandora's Box had been opened, and things were never the same again.

I was an insignificant observer of these seismic events that wrested control from the doctors in hospitals throughout the land. Are things better now? No, how could they be? Those who supplanted the greedy doctors had not the knowledge so to do, then or now. Come back Sr Claude, we need you.

Maurice Neligan is a cardiac surgeon