Unhealthy start to 2008

Heart Beat: I am not apparently the only citizen stupid enough to have some difficulty navigating the traffic hazard that is…

Heart Beat:I am not apparently the only citizen stupid enough to have some difficulty navigating the traffic hazard that is the M50, and the infamous Red Cow roundabout.

The Highest Authority on our journey to Kerry this Christmas wound up in Ballymount with all the consequent trouble in endeavouring to rejoin the M50 and hopefully to manage to locate the N7 before winding up in Belfast.

On this occasion the fault lay not with the National Roads Authority as one might expect, but inexplicably with yours truly who was progressing happily on the correct route some miles ahead. I still haven't figured out how it was my fault but I am a bit slow at times.

I am sitting beside the Christmas tree, unlit as yet to reduce our carbon footprint. Does that sound ridiculous? It does because it is ridiculous.

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I haven't illuminated the tree yet because it is supposed to be daylight. The rain is sweeping across the bay in sheets driven by gale force winds and lightning fitfully illuminates the sombre and threatening background.

It is the post-festivity period with all the usual hangovers - moral, spiritual and real. The Highest Authority is cleaning and tidying and I appear to be something of an encumbrance. Judging by her expression I have the feeling that Lent may come early this year.

Over the holiday we had all our family with us, in a very real sense. This year in particular it meant a lot, and into our hearts and into our homes came many good people who wished us well.

Such support was much appreciated and a great assistance in moving us forward, for that is where we must go. We move on, not leaving something behind but rather taking something very precious with us down all our days.

New Year's Day found me driving the youngest Messr to catch the flight from Kerry airport at Farranfore to London Stansted. We passed through Killorglin and Miltown, both giving a fair imitation of the ghost towns of the old West.

Apart from the occasional individual huddled in a pub door and poisoning himself with nicotine, there was not a creature stirring. Then we came to the city of Firies.

Some may remember it as a small village. It is not so any more. There has been major development here and all the new houses appear occupied and one cannot help feeling that new life is being infused into this old community. Next time through I suppose it will have a mayor and corporation of its own, possibly a centre of medical excellence and at least one decentralised Government department. Such could safely be promised now as there may not be an election for some time.

I don't want to give an impression of frenetic activity in the new metropolis of Firies. Indeed the only movement I noted was an illuminated Santa Claus flying up and down a ladder on the gable of a house, surrounded by bells and all sorts of Christmas paraphernalia. It was a cheerful happy sight; let's ignore the carbon emissions.

A last observation on this trip was that the flight was full and that most of those travelling appeared to be young adults. Many of our people still work on the neighbouring island; I presume now from choice rather than the dire necessity of old.

Over the holiday period I have had the opportunity to meet colleagues from all over the country. Not one of them expected any amelioration in the plight of the health services in the coming year. Wards and operating theatres remain closed; locums at all levels are not employed with consequential effects on service provision.

We start a new year therefore with diminished services already. We start it with too few long-term or continuous care beds. We start it with a 3,000 bed shortfall in acute hospital beds and little prospect of more in the near future. We start it with the shameful situation of our sick and vulnerable lying on trolleys in overcrowded hospitals.

We start it with a deeply divided service with the front-line soldiers on the one hand and the armchair theoreticians on the other.

It does not augur well for the patients of 2008 or for those who struggle to look after them. It was with frank incredulity that the carers heard that the Minister disagreed with elements of the HSE strategic plan for the year ahead. Which head of this Hydra is fooling the other?

It would be nice to write about improvements in the service, but these are few and far between and lost in a dismal sea of defensive incompetence. Reports and plans are hailed as achievements.

There is a limit to spin and concealment. There is a requirement for openness and the acceptance of responsibility. So far there is little sign of either.

The Minister tells anybody who will listen that she will not be diverted from her plans to reform the health service.

I would not describe the jumbled, hypothetical, inchoate nonsense emanating from her department and the HSE as reform while I concede that it will make a difference. It will make matters worse.

Maurice Neligan is a cardiac surgeon.