The capacity of Irish politics to make mountains out of molehills has been in evidence once again in the row over the botched appointment of Dr Tony Holohan to a post in Trinity College. All the usual ingredients, Opposition sniping, media over-reaction and Government weakness combined to ensure that the chief medical officer (CMO) was forced to withdraw from a position for which he was uniquely qualified.
Instead of asking whether Holohan deserved the post, or whether it was in the public interest that his experience of leading the State’s response to the Covid pandemic made him the right person to become professor of public-health strategy, the controversy centred on the nature of the procedure that led to the appointment and where his salary would come from.
If Holohan had been judged on his record as CMO there would have been no doubt that he was the person most ideally fitted to take on the newly-established role, which involved leading a public-health team to explore how the State should prepare for future pandemics.
Excess death rate
An important point of relevance here is that Ireland’s response to Covid was one of the best in the world. A comprehensive survey of the global impact of Covid-19 published by the medical journal the Lancet last month showed that this country had one of the lowest excess death rates in the world.
The excess death rate is a far more accurate guide to the impact of Covid than the numbers recorded as dying with the virus. Many of those who died with Covid, in the developed world in particular, were in the final stages of life and it is only by examining the excess death rate that the impact of the virus can be fully captured.
The Lancet study found that in Europe only Norway and Iceland performed better than Ireland in terms of excess deaths with a total estimated figure for this country of 1,170. The scale of the achievement is illustrated by a comparison with the rates of our nearest neighbours. In the Republic the excess mortality rate was 12.5 per 100,000 people. In Northern Ireland the rate was more than 10 times that at 131.8 excess deaths per 100,000, while in England the figure was 125.8.
The fact that the Republic had such a massively lower excess death rate than Northern Ireland and England is an astonishing achievement. It is one that everybody in government and in the health service can take some credit for but the role played by Holohan was crucial.
Right from the start of the pandemic Holohan established himself as a figure of trust and authority. The public looked to him for guidance and took his advice in a way that they would probably not have done if the message was being delivered solely by politicians.
At times he could appear overbearing and Ministers sometimes resented the way he went public in advance of major lockdown decisions to push them in the direction he thought fit. While this led to occasional tensions ,the net result was that decisive action was taken when it was required.
Central role
There is no escaping the fact that Holohan played a central role in ensuring that the public was given a clear message about how to behave. To their credit our political leaders also acquitted themselves well, taking the medical advice and changing course when circumstances changed.
Of course most credit of all goes to the vast majority of citizens for following the onerous rules about isolation and social distancing that helped to limit the impact of the virus. In some cases this caused acute distress, particularly to people unable to visit dying relatives or having to limit the numbers attending funerals to 10. Yet the vast majority uncomplainingly did what was asked of them.
It should also be remembered that Holohan’s wife was ill with a terminal disease at the height of the crisis but that didn’t stop him from performing his duty as CMO. In the light of such dedication to serving the public interest it is quite appalling that his move to Trinity prompted such a mean-minded response that he felt compelled to abandon the project.
There is surely something perverse about Irish public life in the way negative voices are allowed to dominate the discourse on virtually every topic, even when the underlying story is positive. For instance the Lancet survey quoted above, which reflects so well on the response of the authorities to Covid, generated hardly any publicity. If the report had found the opposite the air time and newspaper column inches that would have been devoted to it can only be imagined.
As well as reflecting well on the leadership given by Holohan and the Government, the survey is a great reflection on the Health Service Executive. Far from having a “third world” health service as so often stated by glib commentators it is actually one of the best in the world. What does it say about our respective countries that people in Britain are generally proud of their poorly-performing NHS while so many people here seem to like nothing better than bad-mouthing the HSE.