Dan Boyle: A Healthy Cynicism


From top: Cork University Hospital, Wilton, Cork; Dan Boyle

The Accident and Emergency department at Cork University Hospital, not unique among Irish hospitals, has in recent weeks not only had far too many people awaiting treatment on trolleys, it also has seen many ambulances queued outside as mobile treatment rooms, preventing them from being available for emergency calls.

It is being suggested, that as a means of dealing with these ongoing difficulties, the hospital should convert its Acute Assessment Unit into a general ward to create additional bed space. I believe that this proposal would not only be counterproductive, it is an idea that is dripping with irony.

The Acute Assessment Unit was developed as an alternative to A and E, a measure that would relieve stress from the usual point of admissions in most hospitals. Initially GPs could refer patients to the unit bypassing the need to go through A and E.

I was a beneficiary of this unit. Around five years ago I acquired a serious bacterial infection. After a visit to my GP, a blood test revealed that my white blood cell count was extraordinarily high. I was the most ill I had ever been in my life.

My GP had me admitted to the Acute Assessment Unit. There I was put in the care of an exceptional consultant and an amazing nursing staff.

I required three laser surgery procedures over three days. The first procedure did not go well. I found myself having difficulty breathing and in a great deal of pain.

It was then I experienced all that is good with our health service. During my difficulty a change of shift occurred, but a junior doctor and the nurse in charge, stayed on a further 90 minutes until I was again breathing normally and the pain had subsided. I will always be grateful for the kindness they showed me.

This I experienced as a public patient. Public by choice. I believe in a public health service. It is one of the obvious failings of the Irish health system that not enough policy makers, and sadly some service providers, don’t.

We spend a lot of money on our health system. More proportionately than our neighbour the UK does on its National Health Service.

Our funding mechanisms are a mess. Around two million of our population are medical card holders at a cost to the State of about €1500 per year per card. This would be divided between holders of hospital service and doctor only medical cards. Two thirds of this cost is spent on drugs.

Two million others take out private health insurance, partially subsidised through tax relief. The average premium is about €2000 a year.

Value for money is not being provided through either funding mechanism. We should no longer accept a bit of this a bit of that approach to our health service.

We should adopt a philosophy that has health promotion ahead of reactive health care. A system which is more community than hospital based.

Health care should not be a lottery. I was lucky, very lucky. I was at the right place at the right time when I became ill. A time when some innovation was being attempted. A shaft of light that allowed a possibility that different might be better.

We seem to be reverting to business as usual crisis management of our health services. This will guarantee ever increasing costs with ever worsening outcomes.

Becoming ill or watching those we care about suffer is already bad enough. Having a health care system that is more ill than we are ourselves, is truly tragic.

Dan Boyle is a former Green Party TD and Senator.  His column appears here every Thursday. Follow Dan on Twitter: @sendboyle

Pic: Denis Scannell

30 thoughts on “Dan Boyle: A Healthy Cynicism

  1. phil

    Dan there is a conspiracy theory out there that the center right parties in both Ireland and the UK are defunding the public health care system in order to encourage a private sector takeover….

    Have you ever seen any evidence of that while you were in Government ?

  2. Dan Boyle

    There were co-location proposals but we nipped them in the bud. Not that we got any thanks!

          1. GiggidyGoo

            You haven’t provided any proof that is was the Greens that put a stop to it. Keep ducking and diving. We have your measure.

      1. ReproBertie

        The Greens were the junior partner in government when the country slid into recession and didn’t solve all the environmental problems so that’s that. Hard luck environment.

  3. millie st murderlark

    It must be said, the comments on these pieces are always so nasty. I can see (rightfully) why there is anger still. We Irish certainly know how to hold a grudge.

    Still, the constancy of the scorn sent Dan’s way is unfathomable to me. Perhaps because once I’ve gone on a screeching rampage of rage, I tend to forget my anger and move on.

    1. Cú Chulainn

      You were never in the GP.. it’s always harder when you of your own let you down. That half wit Ryan got back eventually. I see the no wit Gormley thinks he knows about the film & tv industry. But I don’t see any way back for Dan. Ryan at least admits to having made mistakes. No so Dan the man, who can do no wrong..

      1. Dan Boyle

        Given your tone I suspect everyone in your life has let you down. Careful you don’t choke on that moral superiority.

      2. millie st murderlark

        Thanks for the reply, Cu.

        And you’re right. Not a GP member. No political affiliations at all actually. We don’t really exactly have much by way of choice, do we?

        Lots of illusion of choice though.

  4. dav

    It always amuses me how the #civilwarshirts try and lay the blame for their failures on the junior coalition partners.. deflection methinks

  5. Hansel

    Dan, I think we can all agree with what you’re complaining about and what you’re suggesting, but do you have any suggestions on specific resolutions?

    I’m not trying to be sarcastic/snide here, I just have zero idea of how our health service can be fixed.

    It seems to me that when the HSE was created and nobody lost jobs, that perhaps a lot of middle management was kept on.

    A more holistic approach like you’re suggesting is a no-brainer too, but that will be a medium or long term fix and needs to cover a lot of trajectories: elderly care within the community, better nutrition for all, better lifestyle (exercise) for all, better sleep for all, etc etc etc.

    1. Dan Boyle

      The monolith that is the HSE is most of the problem. A Hospital Agency is needed for major infrastructure spending. A regional structure, much like existed before, is far better to develop a better community care approach. We centralise everything too much. The closer decisions are made to those affected the better such decisions will be.

  6. Dan

    Regional structure only suits the parish pump brigade. Each with its own management, finance, hr etc teams which is a waste of money.
    But, the sort of suggestion I expect from a local election candidate.

    1. Dan Boyle

      My you are angry. Choising selectively to read what I said. A regional structure for community care.

      1. Dan

        What you said was
        We should adopt a philosophy that has health promotion ahead of reactive health care. A system which is more community than hospital based.

        Now who is being selective?

  7. Dan Boyle

    The article says there should be a national Hospital Agency with other services being decentralised. You remain a selective reader.

    1. bisted

      …hey Dan…have you heard Gemma O’Doherty is running for Europe…I take back all I said about County Councils being the last refuge…

      1. Dan Boyle

        She’s running for local elections. As odious as her views are she at least is more prepared to stand by them than you are.

        1. bisted

          …always the hard word Dan…I have relations in you constituancy…and while they would rather chew each others arms off than vote for you, they had agreed for me to move down and stick my name on the electoral register to vote green…any chance of a few bob…

        2. GiggidyGoo

          So, Dan. What was the reason Gormley gave for ending the FF GREEN government? Can you bring yourself to confirm that it was the failure of FF to solve their leadership problem? You keep running from that question, now asked five times. Instead of calling other candidates views ‘odious’, maybe you could answer that one simple question?

          1. GiggidyGoo

            Because there wasn’t any mention of the financial crisis that FF GREENS visited on us. Man or mouse Dan?

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