When the tank in the roof is leaking, and the water is running down a wall, exiting through an electric socket behind the bread-bin in the kitchen, what do you do about it? You can set fire to the bakery that's selling the bread that goes mouldy so quickly, but the chances are that even after you've torched half the bakeries in Ireland, the bread in your bread-bin is turning blue and hairy the day after you bought it. Maybe you should get an electrician to mend the socket, which is always fusing or short-circuiting; and if Great Aunt Maude hadn't been quite such a pest, and her permanent absence not now so thoroughly pleasurable, you might have sued the original installer of the socket after she tried to use the toaster and ending up resembling a chicken wing left on the barbecue overnight.
Plasterer
Maybe after three more family members are electrocuted by subsequent sockets, (and are buried beside the chicken wing in the family vault) you abandon the socket theory and call in a plasterer to deal with the 15 varieties of antibiotic rioting on your kitchen wall. Next day, the fungal tulle is back, along with several kinds of toadstool hitherto unknown to science. You can book the plasterer again, and he'll grub out the hedgerow of fungus and replaster. But by next morning . . .
Or you can get a plumber in. Several years after the initial phone call, he'll turn up, and for the price of an acre of Custom House docklands will mend your invisible water-tank - the reason for your bread problems, your electrical problems, the mushroom farm on your kitchen wall, any why the chicken wing is in Mount Jerome, her nieces and nephews neatly stacked beside her.
Our hospitals are like the kitchen. You can spend a fortune on them, rewiring them and replastering them and generally making them Maude-friendly, but they still turn into a cross between an electric chair and the linen cupboard in the Titanic circa 1919 unless you attend to the leaking tank in the roof. Hospitals are at the bottom of the problem-bearing downpipe of Irish society; and far from the caricature of hospitals neglecting the poor being true, the poor are - quite properly - the largest users of our hospitals, as the large numbers of adults with trainers, tracksuits and a smoker's cough in any outpatient or casualty department might suggest.
Saying that the poor don't live as long as the better off is as useful as saying they haven't got as much money: and whoever is to blame for that is not the medical profession. Doctors didn't site sink-housing estates miles from Dublin city centre, nor do they encourage the poor to drink or smoke as much as they do; and, as every survey shows, they do to chronic, often catastrophic levels. You doubt it? Spend half an hour in a pub frequented by the impoverished.
Public workload
It's absolutely true, however, that most consultants don't put in the 33-hours per week for which they're paid. Most consultants I know would be very happy indeed to have such a small public workload. One week in Tallaght Hospital - oops, sorry, The Adelaide and The Meath, Incorporating The National Children's Hospital - hardly makes me an expert. But when I saw consultants arriving in the public wards at 7.30 in the morning, and when I saw them in those same wards at nine at night, I rather suspected a lot of them would be happy to settle for a 33-hour week.
The truth is not that we're paying doctors too much; we're not paying them enough. All the people we called in to look at our kitchen - the electrician, the plumber, the plasterer - earn more money than hospital consultants these days. Yet despite our niggardliness, we have ludicrously raised expectations of our medical service. We watch British television, we read British newspapers, and we hear about a National Health Service which we think we should have, even though the NHS is two things: (a) free at source; and (b) falling apart. Is there a connection here? I suspect there is. Let us ask another question. Is there a connection between (a) the widespread belief that our hospital consultants are overpaid, and (b) that 80 per cent of registrars are non-Irish? Does not proposition (b) disprove proposition (a)? If our doctors are overpaid, why are we so dependent on immigrant doctors?
Public relations
We've all have heard of doctors whose bedside manner is to bad they shouldn't be allowed to take the pulse of an ailing earthworm, never mind that of a frightened human being. Indeed, bad-doctor stories are as much a conversational staple as traffic jams, Dublin Airport and property prices. In part, this is because the profession as a whole has the public relations skills of the Borgias.
But personally, as opposed to urban myth, how many bad doctors have you ever come across? Few, I'd wager. Our anecdotes about the medical profession are prompted more by envy than by personal experience: for doctors appear to have power over life and death. Yet, as doctors will be the first to tell you, they haven't that power: they can merely prolong one and defer the other. And in our hearts, we know that too. That is why, for all the unpaid hours, unseen, unacclaimed, that most doctors put in, we can never love them. For in the mortal end, we know that, without exception, the medical profession will let every single one of us down.