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Dr Anthony O'Connor History matters, but the record numbers on trolleys should trump commemoration debates

Why are we fighting the battles of the past rather than honouring the ideals of the Republic?

IT WAS ANNOUNCED this week that all elective surgery in public hospitals in Cork and Kerry, an area with a population of almost 700,000 people, would be cancelled until further notice due to unprecedented levels of overcrowding in the region’s emergency departments.

Elective surgery is a term that encompasses all non-emergency, planned procedures.

These are not trivial entities and may include cancer surgeries, repair of blood vessels that are at risk of rupture, joint replacements for patients in chronic pain, among others.

It was therefore no surprise to hear several senior politicians on the airwaves in recent days discussing the important issues of the day.

Except they weren’t discussing the situation in our hospitals, rather the proposed commemoration of officers of the Royal Irish Constabulary.

For me, the juxtaposition of these two news stories summed up the way civic Ireland, once so outraged about healthcare, now merely shrugs its shoulders at the perpetual overcrowding crisis in our hospitals.

A shameful record smashed

Today’s figures from the Irish Nurses and Midwives Organisation (INMO) show there are 621 patients on trolleys in Ireland’s hospitals.

On Monday, 760 patients were on trolleys, a new all-time high.

There was a time when this would have dominated the airwaves, and the major TV current affairs shows.

No longer.

What did Liveline and the Claire Byrne shows lead with on Monday?

The Black and Tans.

If it is to be our lot as Irish people to be, in the words of the great Strabane songwriter Paul Brady “still trying to reach the future through the past”, is there anything we can learn from revolutionary times that could help our crisis-stricken hospitals?

I argue yes.

the-opening-of-dail-eireann-or-chamber-of-deputies-of-the-irish-free-state-parliament-dublin-ireland-on-september-9-1922-from-the-story-of-25-eventful-years-in-pictures-published-1935 The opening of Dáil Eireann in September, 1922. Ken Welsh Ken Welsh

This was not part of the plan

Ostensibly, what the RIC and the Irish Volunteers were fighting about 100 years ago was the right of the Irish nation to constitute itself as a republic, in line with the Democratic Programme of the first Dáil, drafted by the then leader of the Labour Party, Tom Johnson.

This document states that ”The Nation’s aged and infirm…shall not be regarded as a burden, but rather entitled to the Nation’s gratitude and consideration…it shall be the duty of the Republic to take such measures as will safeguard the health of the people and ensure the physical as well as the moral well-being of the Nation.”

If those who wrote the Democratic Programme, and gave their lives in those tumultuous days were to come back and revisit us, I would be confident that they would concern themselves more with the welfare of Irish children in their infirmity than the re-telling of battles fought and atrocities perpetrated a century ago.

More boldly again, the Democratic Programme affirms “that all right to private property must be subordinated to the public right and welfare”.

A two-tier system

Ireland operates two parallel, yet intertwined healthcare systems, one public and one private.

The private system provides modern, comfortable facilities, and timely, efficient, high-quality access for a reasonable range of medical conditions, which eases the pressure on the public one.

For its part, the republic provides massive direct and indirect subsidises to the private sector.

Directly, the National Treatment Purchase Fund spent €75 million in 2019 purchasing services from the private sector.

Many of the private hospitals in the state availed of generous tax breaks for their construction in the early part of the 21st century.

Indirectly, the private sector benefits greatly from the publicly-delivered training of healthcare staff.

In addition, when patients experience complications in private hospitals, or when those hospitals are full, the patients are transferred across to public hospitals, at no charge to the private hospital.

Also, most private hospitals, particularly those in Dublin have rarely had to worry about recruiting and retaining consultant staff.

They have simply been able to piggyback on the recruitment of high-quality doctors by neighbouring public hospitals and been able to offer them increased earning potential without inconveniences, such as having to provide for their pensions, for example.

Not a bad set of subsidies for these hospitals, all things considered.

Some private hospitals are financially thriving, others are finding the going more difficult, with the Mater Private group for example being reported as having recorded a €23 million loss last year.

Unsurprisingly, elective surgery is not cancelled in private hospitals at the moment.

In spite of what some of my more excitable colleagues may think, nobody is talking about sending in the tanks to seize private hospitals, but could the nationalisation of some or part of these facilities be an option to alleviate our crisis?

This is not without precedent.

Mount Carmel hospital in South Dublin had previously been best-known as the place where the babies of Ireland’s rich and famous came into the world.

However, in 2014, liquidators were appointed by the High Court and the hospital closed its doors.

The minister of the day, James Reilly told the Oireachtas at the time that nationalising the facility would not be workable, yet 6 months later the state did exactly that with the HSE purchasing it from the liquidators for €11 million.

The hospital is now a thriving public facility providing Step Down/Step Up Beds, Transitional Care Beds and Rehabilitation Beds, staffed in partnership with private sector agency Mowlam Healthcare.

Few would argue that the people of the community are not better served by what is there now than what was there before.

Many will argue that the state has proven itself unworthy to run hospitals, but the state is the only game in town when it comes to full-service hospital care.

There are no private maternity hospitals, rehabilitation hospitals, stroke units, hospices, or crucially, emergency departments that open 24/7.

Others will baulk at giving the state more hospitals to run when it struggles with the ones it already has, but the truth is the state is planning to build several new elective-care hospitals around the country anyway.

The answer could be simpler

Given our experience with the children’s hospital, would it really be that terrible an idea to think about buying ready-made, currently operational facilities instead as a faster and more efficient means of improving the service?

It may seem unthinkably complicated now, but nationalising the banks was unthinkable once too until we woke up one morning at a time of crisis and it had happened.

The most dangerous thing I see at the moment is the apathy with which we have greeted 760 people on trolleys waiting for beds.

And it is ineffably depressing that we, as a people, are more interested in fighting the battles of the past, rather than honouring the ideals of a republic that were fought for.

James Connolly exhorted us to “draw inspiration not from the mouldering records of the past, but from the glowing hopes of the living present, the vast possibilities of the mighty future”.

We owe it to all of our antecedents, regardless of who they fought with to do better. Radical change is needed.

Dr Anthony O’Connor MD, MRCPI is a Consultant Gastroenterologist at Tallaght Hospital.

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    Mute Biróg
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    Mar 19th 2017, 9:56 AM

    The new Journal comments are a complete disaster. Huge Duplo style gaps fits about 4 comments per page and no red thumbs. I think this will damage thejournal. If I were to return I may even have to read the articles.

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    Mute The Girl
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    Mar 19th 2017, 11:19 AM

    @Biróg: I totally agree. Bring back the comment section. This one right here, I dont know what it is. Please :-(.

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    Mute Eye_c_u
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    Mar 19th 2017, 10:23 AM

    My eyes….. the goggles do nothing

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    Mute Damocles
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    Mar 19th 2017, 9:34 AM

    I hope they remembered their lead lined underpants.

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    Mute Suzie Sunshine
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    Mar 19th 2017, 12:24 PM

    Great photos .I watched a documentary about this and from what I remember I think there is one man who refused to leave and still lives there . He looks after the animals that where left behind .he said he couldn’t abandon them ..

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    Mute Gary
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    Mar 19th 2017, 2:57 PM

    Suzie, that was Chernobyl. Everyone near Fukushima had to leave.

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    Mute Suzie Sunshine
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    Mar 19th 2017, 3:25 PM

    @Gary: no it wasn’t Chernobyl. . Joanna Lumley did the documentary. .

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    Mute Suzie Sunshine
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    Mar 19th 2017, 3:25 PM

    @Gary: no it wasn’t Chernobyl. . Joanna Lumley did the documentary. .

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    Mute Suzie Sunshine
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    Mar 19th 2017, 3:25 PM

    @Gary: no it wasn’t Chernobyl. . Joanna Lumley did the documentary. .

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    Mute Suzie Sunshine
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    Mar 19th 2017, 3:25 PM

    @Gary: no it wasn’t Chernobyl. . Joanna Lumley did the documentary. .

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    Mute Suzie Sunshine
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    Mar 19th 2017, 4:05 PM

    @Suzie Sunshine: sorry about multiple posts ..anyway. . It’s called Joanna Lumley Japan. . Well worth a watch .

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    Mute Oliver Cullen
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    Mar 19th 2017, 6:56 PM

    @Suzie Sunshine: can u recall the name of the documentary?

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    Mute Suzie Sunshine
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    Mar 19th 2017, 7:23 PM

    @Oliver Cullen: Oliver it’s on tonight at 10pm on be3 .. Joanna Lumley , Japan ..

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    Mute Liam Byrne
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    Mar 19th 2017, 3:28 PM

    I wonder what has happened to the mortgages on all those properties. The insurance on all the goods…

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    Mute Roger Smith
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    Mar 19th 2017, 11:10 PM

    Fukushima is a great media scare story: If one flew from Europe to the evacuation zone and stayed three weeks there, the biggest dose of radiation one would get would be from the background cosmic radiation on the plane flight there and back. Kerala in India has a higher natural background radiation level that the Fukushima evacuated zone. But the headline “nuclear power not really dangerous after all” wouldn’t sell many newspapers or get people to watch TV programmes.

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    Mute William Grogan
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    Mar 19th 2017, 9:43 PM

    The authorities TOTALLY over reacted. There was no need to evacuate so many people. The levels of radiation are harmless.

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    Mute Ronan Gallagher
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    Mar 19th 2017, 10:14 PM

    Radioactivity has been found in the waters off the west coast of the Us. Fukushima is still leaking. Robots have been sent in to investigate but break down due to the extreme amount of radiation. Fukushima is way worse than Chernobyl.

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    Mute William Grogan
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    Mar 19th 2017, 10:35 PM

    @Ronan you haven’t a clue have you? Not an iota. The seas are radioactive. You’re radioactive. Fukushima added feck all radiation to the oceans. Go back to school, you left too early.

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    Mute Mjhint
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    Mar 19th 2017, 10:39 PM

    @Ronan Gallagher: no Rogan this has proved to be false. YouTube thunderf00t will explain why it’s not the case. The only people that died in Japan were old people that were evacuated. Fukushima is just like chernobyl. It’s a big disappointment for those that still say nuclear power stations are too dangerous. It’s still the safest power generation system on the planet.

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    Mute Ronan Gallagher
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    Mar 20th 2017, 6:45 AM

    Ah William. I’m talking about high levels of radiation. One of the reactor cores has melted through the steel floor and is leaking into the sea. Robots have been sent in to investigate but burn out due to the high levels of radiation. The highest ever recorded.

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    Mute William Grogan
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    Mar 20th 2017, 8:21 AM

    @Ronan What does “high” mean? The radioactive material released into the oceans from Fukushima are MINISCULE in comparison to what’s there already. What causes those of you that are scientifically illiterate confusion is that some relatively short lived radioactive elements can be detected in minute quantities very far away. These short lived radioactive elements can only have come from Fukushima because they decay to non radioactive elements very quickly. However the dose anyone would get, including fish, is far less that the normal background levels.

    You didn’t answer my question. You know nothing about Physics, do you? Admit it.

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    Mute Ronan Gallagher
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    Mar 20th 2017, 11:43 AM

    530 sieverts per hour was the latest released reading early February. Cesium 134 has recently been read in the waters off the coast of Oregon and also in Canadian salmon. Cesium 134 is the fingerprint from Fukushima. All of this info is openly available.

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    Mute William Grogan
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    Mar 20th 2017, 11:56 AM

    @Ronan I already pointed out that it’s a characteristic of radioactive elements that ones produced in NP plants can be detected the far side of the world in minuscule doses but so can a message in a bottle. The fact that you can detect it doesn’t IN THE SLIGHTEST mean it’s dangerous. Radiation in low doses is simply not dangerous. We live in a radioactive world.

    The radiation levels from Fukushima outside the plant are not dangerous. Bar a few crackpots and the scientifically illiterate who write nonsense on web sites no one believes otherwise. Canadian Salmon already contain “naturally produced” Uranium, as do you. You have about 100,000,000 atoms of radiation emitting Uranium in your body + Radium and Polonium and lots of others. Does that bother you?

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    Mute Ronan Gallagher
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    Mar 20th 2017, 7:52 PM

    Are there any newspaper, magazine or independent journalists you believe or are they all crackpots? Where do you get your info about fukushima or have you been there and personally investigated the site?

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    Mute William Grogan
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    Mar 21st 2017, 8:46 AM

    @Ronan I only get and pay attention to information on scientific matters from Scientific journals or Science books. I’m not interested in the opinions of lay people or non-scientists. So the Daily Mail, the Irish Times, The lying Indo, RTE are out as are most newspapers and popular journals such as Hello. Unfortunately most articles written about scientific matters by non scientists are rubbish, biased, inaccurate, or are written by people with an agenda.

    Start reading Scientific American or New Scientist and you will find that scientists do not expect a SINGLE death from radiation caused by Fukushima. I also recommend a book on radiation called “Radiation & Reason” (get it on Amazon) written by a Physicist and an expert on the effects of radiation on health.

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