The Wrong Diagnosis

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From top: Minister for Health Leo Varadkar; Dr Julien Mercille

Leo Varadkar’s views on hospital overcrowding and abortion shows he is not fit to be Minister for Health.

Dr Julien Mercille writes:

This weekend, Niamh Horan in the Sunday Independent had a great interview with Minister for Health Leo Varadkar (see also the related article here).

Ms Horan seems to have a knack for extracting nuggets of information from politicians, having done the same last week with macho-man Alan Kelly from Labour, who boasted that “Power is a drug… it suits me”.

Leo made a number of astonishing claims that cast serious doubts about his understanding of health and health care. In other words, the interview proved that it’s not because you’re Minister for Health that you know anything about health.

First, he stated bluntly that cutting resources to hospitals was a good thing.

You would have expected that a pro-austerity Minister well-trained by public relations advisers would have said something like “Listen, I know cutting funding to hospitals is not good, but we don’t have a choice”.

But no, he said he does like the policy of cutting funding to hospitals because he thinks it makes nurses and doctors work more efficiently when they’re under pressure. Leo said:

“What can happen in some hospitals is sometimes, when they have more beds and more resources, that’s what kind of slows it down.”

Really? And why is that?

“Because they [hospital staff] don’t feel as much under pressure. So when a hospital is very crowded, there will be a real push to make sure people get their X-rays, get their tests and, you know, “let’s get them out in four days”.”

Nevermind if they need more than four days, they get out in four, and we push the problems down the line as usual, when those people will come back to the hospital because they were discharged too quickly and they haven’t healed properly, and their condition may even have worsened.

What Leo said is simply not true, as anybody working in a hospital will tell you. When you’re under pressure, you speed up, and you make mistakes and you cut corners. Medical staff work with people’s lives and they need to take the time needed to do what needs to be done.

I can hardly imagine Leo himself on the operation table telling the surgeon and his assistants: “hurry up you don’t have time to do it 100% because you need to go meet other patients”.

Nevertheless, Leo made the incredible and wrong claim that “more beds and more resources do not relieve overcrowding” in hospitals.

Well, yes: more beds do relieve overcrowding, by definition.

It is true, however, that more funding is not the only solution to the health care system. The main problem is the type of system we have.

Anybody working on health care needs to know something: a tax-funded public health system like the NHS in the UK is the best system that exists and it is what we should aspire to. It is both cheaper and it is better for health.

The reason is that in privatised systems, there is a lot of bureaucracy involved and that’s very expensive. Armies of clerks and office workers need to compute the price of every treatment, process claim forms, reject claim forms to try to save money for the insurance company, send glossy letters to insurance policy holders, etc. All that costs a lot of money and this is why private for-profit systems are more expensive than public ones. It’s very well-established through health policy research.

There is therefore no reason for Leo not to know that. Why is he privatising our system then? It’s not because people want that.

Indeed, the one issue that is the most important to Irish people, poll after poll, is health care. Therefore, the government is completely at odds with the population in that it acts to worsen the trolley crisis, cut funding to our hospitals, increase crowding in our hospitals, and privatise the system even if this is amounts to a waste of money.

The second point Leo made in the interview is about abortion. Niamh Horan pushed him but he simply refused to give any answer that would mean that he wants to liberalise abortion laws significantly.

Leo has stated that he is “pro-life”—that means, cutting through the spin, “anti-choice” or “pro-the government deciding for women and their partners what’s best for them”.

This means that the Minister of Health does not want health care in this country to provide an important service for women’s health.

In fact, it appears that Leo doesn’t even understand the issue of abortion. Here is the exchange with Niamh Horan:

Niamh Horan: “Do you believe abortion in Ireland is a class issue?”

Leo Varadkar: “No [laughs]. I don’t know what that question means.”

Horan: [I explain that a woman who is wealthy and can afford to travel to the UK has greater access to a safe abortion and medical care than a woman who has no access to similar funds]

Varadkar: “No, I don’t think it’s a class issue.”

In sum, what the above reveals is not so much ideological differences as a failure to know and understand the basic facts about health and health care. If we agreed on the basic facts but had an ideological argument, at least, we’d all be living in the real world. But here we have a more fundamental problem with getting the facts straight.

It reveals incompetence of the highest order.

A Minister for Health who believes that overcrowding is a good thing and that refuses to provide abortion services like everywhere else in the Western world is not a Minister of Health.

Julien Mercille is a lecturer at University College Dublin. Follow him on Twitter: @JulienMercille

57 thoughts on “The Wrong Diagnosis

  1. Owen

    I’m fairly sure Leo sees his entire role is a popularity contest to try bring him further in a political carer. He is not a good minister, he is not intelligent and I fear he will be around for years due to popularity and nothing more.

    1. han solo's carbonite dream

      i’m not a fan but to say he isn’t intelligent is silly.
      he is smart enough
      respect your enemies…

        1. The Real Jane

          He’s intelligent but he doesn’t sound like a thoughtful or reflective individual. These are extremely ideological answers which suggest that he’s more interested in what FG pollsters reckon their constituents want to hear than any considered ethical position.

  2. Tish Mahorey

    And now for the Young Fine Gael UCD Smurfit Business School Broadsheet Special Ops Team……

  3. donal

    I distrust Leo as much as i distrust the rest of FG, they are neo-liberal to the hilt, privatise privatise privatise, they enact policies that help the rich get richer and the rest of us just struggle on by, struggle to pay insurance bills or struggle on a waiting list. I hope they lose.
    As for his lack of ability to understand class issue of abortion, well, when you have money you think everyone does I guess

  4. Rob

    Just because someone doesn’t agree with you, especially on a divisive issue, doesn’t make them incompetent.

    1. Harry Molloy

      spot on

      Surely, in order to be a worthy columnist, you should at least try to understand both points of view. I know a few doctors and most are pro-life even though their friends/family would ,mostly be pro-choice. It could be down to education, i.e. they spend 8 years learning how to maintain and save a life so terminating a foetus just goes against their gut.
      Doesn’t make them incompetent doctors. Wouldn’t make them incompetent health ministers. It’s just their opinion.

      And if Julien wants to be taken seriously, then lauding Niamh Horan isn’t the way to go about it. Unless he’s tryin’ to get in there, wha’!

  5. 15 cents

    and i thought Leo was the one intelligent member of FG. he’s had a fair few worrying clangers. why the hell are FG leading the polls? i hate you all for probably putting these eejits back in for another poxy 5 years.

    1. Tish Mahorey

      “why the hell are FG leading the polls?”

      70% don’t want them. Leading the polls would be a misinterpretation of what’s going on.

      1. Harry Molloy

        silly logic, there’s more people who don’t want every other party, they have the highest % therefore are leading,
        If you don’t like them that’s grand but people will completely write off your opinions if you come across as being a fool

  6. Paul

    I read as far as Dr. Geog’s praise of Niamh Horan and then stopped. I think he has found his level.

  7. ahjayzis

    No minister with private health insurance is ever going to abolish the two-tier system and find themselves and their loved ones mixing with the proles. Just not going to happen.

    I’ll take a health minister seriously when he’s committed to using the public health service for his own family.

  8. h

    I nearly had a row with my mother last night because she said she thought he was a good politician and I said I’d count my fingers if I ever shook his hand…

  9. Pardon

    I am finding it rather difficult to digest this “copy and paste” gibberish from Mercille . IS there supposed to be a point to this badly written , incoherent ode to fatuousness?

    1. Harry Molloy

      The point is he identifies as left so cannot see any positives in the current administration whatsoever. Big lefty head on him.

    2. jambon

      Yes, try giving it another read, maybe just the bold bits, there aren’t too many big words there, pet.

  10. ollie

    Pardon, if you are having difficulties understanding this article then you should probably claim disability allowance.

  11. J

    No comparison done on UK spend on public healthcare V Irish spend on public healthcare.
    No consideration given to the way the NHS shuts down hospitals which are proven to be ineffective and inefficient. Roscommon revolution anyone?
    No thought given to cost/tenders/budgets nor the current decline in the NHS. No analysis or discussion of the two differing healthcares. No facts. Nothing.
    Mercille deals more jokers than a Vegas casino dealer . I was considering a BS divorce but given the current levels of dissatisfaction cursing through my veins, I think an annulment may be on the cards.

      1. J

        Frilly, I am a glutton for punishment so I will hang on in until Friday. Just promise me that you won’t taunt us with some interview with Jules. I can no longer tolerate the Dublin taxi driver’s definition of pillow talk. Me nerves. Me nerves.

    1. classter

      J, you’ve hit the nail on the heat re Merceille. He just never gets beyond the initial ranty thesis.

  12. Eoin

    Leo seems to be one of those new political sorts who gets stuck out front in the tough jobs and takes all the flak while the senior politicians sit behind the scenes issuing the orders. I guess the promise of a long, lucrative career shafting the country, followed by a sweet job from whatever special interest group they pander to, appeals to these sociopaths. And the old guard get to avoid the flak. I mean, do they advertise for patsies among the parties membership? How did Paschal O’Donohue, Leo Varadkar, Alan Kelly etc. etc. and their ilk even get ministerial positions? They didn’t earn them anyway. Patsies for the old guard. Unfortunately these clowns are in positions of great responsibility. Their incompetence will cost lives.

  13. Nice Jung Man

    This article about irrelevant nobodies is down to the usual low standard from the hack doctor

  14. rotide

    Sorry, what exactly IS mercille? A geography professor? An ‘expert’ on the media?

    What the f&&k does anyone care what his opinions on healthcare are?
    Particularly love this:
    “Leo has stated that he is “pro-life”—that means, cutting through the spin, “anti-choice” or “pro-the government deciding for women and their partners what’s best for them”.”

    Good man Jules, You;re going to cut through the spin WITH YOUR OWN SPIN.

    I’m going to assume he’s just a mate of JRs and gets published here as a favor like Leather Jacket Guy.

    1. Tish Mahorey

      Here we go. Rotide in with the personal attack a la Fine Gael.

      “A geography professor?”

      As if that’s ridiculous. Probably far more informed and intellectually capable than a herd of BMW driving Leinster Fans all droning on about their financial adventures and their Stepford wives who they shared around before marrying.

    2. J

      @Rotide To answer your question. Mercille is a lover of delusion, a mate to narcissism and an enemy of analysis and fact. This is not an opinion. This is fact. You can fact check it to the beginner’s guide for journalists.

  15. Anne

    “Ms Horan seems to have a knack for extracting nuggets of information from politicians,”

    A good pair of knockers will get you any information you want.. usually.

    1. Junkface

      That has no effect on a Gay man. He’s not into ladies knockers. He’s into looking at his own junk judging by that photo.

  16. TheDude

    It must be Leo’s many years of working at the coal face in our hospitals that gives him this enlightened insight

  17. Kieran NYC

    So Mercille seems to be arguing against efficiency in the health system?

    Seems to me that Leo was arguing Parkinson’s Law: “Work expands to fit the time available”.

    Or maybe he really is some kind of granny-killing monster as Julien says.

  18. Fergus the magic postman

    I cannot believe how anybody could have an issue with Varadkar saying that hospital cuts were good because they make doctors & nurses work more efficiently, and a lack of hospital beds has nothing to do with overcrowding.
    The man’s a genius and should be left alone! They should make more cuts, & cut the number of beds further. He’ll have the health system running like a well oiled machine in no time!

  19. Condescending Nana

    certainly more experience in him being a GP than you being some cheap controversialist who takes quotes out of context, you got the looks, move onto modelling perhaps leave real world politics to adults?

      1. Marina

        Very curious to know what hospital you have experience of Fergus? My own recent experience with family members has been pretty horrific.

        1. The Real Jane

          My recent experience of the place known as Horror St contradicts it too. I’m never having another baby as a result, but I can afford all the abortions.

          You’d think the pro lifers would want to make maternity hospitals cushy, but they really don’t appear to.

        2. Fergus the magic postman

          Mine is similar to yours & everyone elses Marina.

          I’m pretending to be in denial, like some of the other users on here. It’s a joke the lengths some go to defend the state of things. If I was to carry on my charade, I’d be calling you a shinner-bot now for disagreeing with me, before adding something about the wonderful economic recovery we’ve all been experiencing

  20. some old queen

    In all the posts on this thread, mainly bitching at Mercille, not one has addressed his two main points. That a private health system is a very inefficient means delivering health care and that the vast majority of people support an NHS. And yet, for reasons that have never really been discussed, the system is still going backwards.

    Why is that? Why is a country like Ireland which has experienced so much positive change in the past twenty years been unable to maintain let alone improve on a health care provision system that is so obviously the most cost effective?

    1. Same old same old

      It’s glib and fatuous to say “we support an NHS”
      What does that phrase mean? Dollars, cents, euros, five year plans please

          1. some old queen

            My question is as above. Please read it again. Or better still, let me answer it for you. The reason why the NHS is failing is because of an undemocratic political ideology which no amount of first year business studies qoutes will hide. MORE managers and consultants are not the answer.

            How can Cuba which is a very poor country not only have a world class system but is setting global standards in screening? If the will was there, we would have that too.

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