Madam, - The Coalition's progress report on its first year in office is highly illuminating.
Mary Harney makes it clear that the overriding concern of the Government is to complete its full five-year term in office. Meanwhile Bertie Ahern states: "I have lots of abilities but I can't drive the Japanese economy, I can't drive the American economy. All I can do is manage the Irish very well."
This Pontius Pilate attitude won't wash. If the Government is not responsible for the present state of the nation, then a fortiori, it was not responsible for the prosperity arising from the Celtic Tiger.
There are only three basic precepts of management: keeping things going, coping with breakdowns, and doing new things. The Fianna Fail/PD axis is just about managing the first, doing the second very badly, and the third not at all.
The reality is that in education, for example, the reason for inadequate school building has its roots, principally, in mismanagement over the past six years. At a time of unparalleled resources there was no acceleration of the school building programme, due to a work to rule by technical staff in the planning building unit and an inadequate number of planning staff. Money which was available for this purpose remained unspent. Thus, we have the present disastrous situation.
In a recent series of article in The Irish Times Maev-Ann Wren has outlined some of the main fault lines in the health service. Two years ago I heard her talk along the same lines in a lecture she gave at the Colmcille Winter School in Churchill, Co Donegal. She also wrote several articles in The Irish Times at that time. It all wasn't palatable to elected representatives but it was highly relevant. No-one was listening.
The neo-liberal economic policies which seemed so attractive in the boom years, are now proving inimical to the proper management of a European liberal democracy such as this country surely is or aspires to be.
The Taoiseach is right in a way. This Government has "managed the Irish" very well; managed to con them up to their two eyes. - Yours, etc.,
Cllr JIM D'ARCY, Fine Gael, Blackrock, Co Louth.
Madam, - As a retired medical consultant I have been reading Maev-Ann Wren's comments on our health service with interest. One point which never seems to be made is that consultants' salaries are abated (in the Eastern region by 20 per cent) because of access to private practice. I am surprised that Miss Wren, the daughter of a consultant herself, appears unaware of this. On second thoughts, perhaps it suits her left-wing, anti-consultant views better not to mention this fact. - Yours, etc.,
ROBERT P. TOWERS, Shrewsbury, Dublin 4.
Madam, - When I was a junior doctor, I worked in so-called centres of excellence and small general hospitals and after six o'clock at night I was the only doctor you saw, unless a patient deteriorated quickly.
It wasn't just the consultants who had a problem with seeing patients in the middle of the night, in one "centre of excellence" I had difficulty getting some of the registrars out of bed to review an urgent case for me.
There are always going to be mistakes in medicine because risk management is difficult to apply in health care - every consultation carries a significant risk. The greatest risk to patient care is poor supervision and excessive workload. My supervision was non-existent in both types of hospitals but the smaller hospital gave me more time to assess the patient.
I believe in the centre of excellence concept as the way forward but we know that for 30 years, so why has it not happened? Tackling the problem associated with consultant contracts, small hospitals, two-tiered system, waiting lists, junior doctors, etc., are unlikely to stir cerebral cortical function in the brain of many politicans. Like Irish society in general, the health services peacefully operate in an environment of discrimination, inequality, racism and vested interests.
The only way to radically reform the health services would be to look for a politician who feels strongly about the health services and who has the intelligence and guile to take on all the above issues. This person must also be given the reassurance of being allowed to implement his or her plan without political interference for at least three years. The final and most important trait that this politician must possess is the ability to commit political hara-kiri. Because any politician who has made a meaningful contribution to the health portfolio was castigated while doing it i.e. Noel Browne.
As long as the Minister for Health sees the job as a stepping stone rather than the end we will continue to have the present health service.
We have all the reports we need; political will is all that is lacking for us to take the first tentative steps to an acceptable health service. Talking about a world class health service is only for the spin-doctors. - Yours, etc.,
Dr. LIAM TWOMEY T.D., Dáil Éireann, Leinster House, Dublin 2.