A pervasive and systemic disease

I’ve just bought “The Bitter Pill”, a book that exposes the brutal reality of our so called health system. The junior doctor who wrote the book felt it necessary to do so anonymously for fear of reprisal – a damning indictment of our low quality democracy.

I’ve only read the first 30 pages and already I’m angry. Here are some quotes.

Page 9:

“For the past few years I have had access to the health services from the inside. It is this insider’s perspective that is so often lacking in the media-driven analysis of the problems plaguing the heath system.

The horrific stories we read every day in the newspapers and hear on the radio – people left on trolleys in A&E; gross mismanagement of patients in ludicrous circumstances; a young mother turned away from hospital, only to be discovered later, drowned in the river with her two young children – these stories, while undeniably inexcusable, are not actually the problems, but rather the symptoms.

They are the horrifying results of a deeper, pervasive and systemic disease that has colonized the Irish health system and threatens to disable it entirely.”

Page 21:

“I was working in a job where the level of disrespect toward patients was intolerable.”

“When you see a person’s basic human rights violated without cause, it makes you evaluate things in a different light.”

“I saw the basic foundations of good medical practice ripped apart on a daily basis, and I came to the point where I was no longer able to tolerate it.”

Page 22:

“I began to realise that the biggest problem with the health service was the lack of candid information available to the public about its failures.”

“I have known doctors whose careers have been jeopardized as a result of speaking out about bad practice in the workplace.”

“I am in no doubt that were my identity to be revealed, it would greatly diminish my future prospects and possibly even force me to go to another country if I want to continue practicing medicine.”

“I can no longer stand idly by and watch the simple things ignored, watch patients, nurses and doctors pay the price for bad policies that serve the interests of everyone but the public.”

The comment at the end of page 9 is the most telling:

“They are the horrifying results of a deeper, pervasive and systemic disease that has colonised the Irish health system and threatens to disable it entirely.”

I would apply the comment to the administration of Ireland as a whole, changing it accordingly:

“The many horrifying acts of incompetence and corruption that reflect a deeper, pervasive, and systemic disease that has colonised every level of Irish society.”

Frustrated Mary

Just came across this article from the 5th October (Sub. Required).

Mary Harney is expressing frustration with the media for asking questions about waiting lists. Like all Irish politicians Mary has an amazing capacity to drift off into wonderland when reality tries to encroach on her world.

According to Mary being on a waiting list is no different than waiting for a bus.

“Every day of the week there’s people waiting for buses but we don’t talk about people waiting for buses”.

Mary doesn’t have to wait for a bus; neither does she have to wait for health care.

She will never find herself in Susie Long’s position, waiting to die because she couldn’t afford health care.

Mary is just frustrated, she’s lucky

Bureaucracy, responsibility and confusion

Some years ago I had occasion to make a complaint to the then Southern Health Board regarding the abuse of a patient by hospital staff. I remember being angry when my letters were completely ignored and subsequently experiencing total confusion on the phone in my attempts to track down the person responsible for dealing with such complaints.

I can therefore, to a degree, sympathise with Minister for Community, Rural and Gaeltacht Affairs, Eamon Ó Cuív who has admitted that he cannot make head nor tail of the Health Service Executive (HSE).

Speaking on Drivetime (3rd Oct.), the Minister was clearly frustrated at the level of impenatratable bureaucracy in the HSE. He spoke about giving millions to the HSE and now he can’t even get an invoice from them.

I say sympathise to a degree with the minister because, of course, he and his colleagues are fully responsible for creating the rampant bureaucratic monster that the HSE has become.

When it became obvious that politicians had neither the courage nor ability to resolve the chronic mess they had made of the ‘health service’ they simply abdicated all responsibility by creating an ‘independent’ HSE.

Minister like O’Cuiv and Harney are now lining up to complain about this incompetent bureaucratic monster as if they had nothing to do with its creation and have no responsibility in bringing it to heel.

This matter and some other political shenanigans are cogently analysed in today’s Irish Examiner.

Corruption kills

The following is a transcription of an interview by Miriam O’Callaghan with Susie Long, a terminally ill patient, on last Thursday’s Prime Time. There is no need for any comment.

Miriam O’Callaghan:

Earlier this year a really courageous woman went public about her experiences in the health system when she became terminally ill with cancer because, as a public patient, she had to wait seven months before getting the necessary tests.

She’s now in our Lady’s Hospice in Dublin


Susie, how are you at this moment?


I’m feeling ok, I’ve been told I don’t have that much time left but I plan on proving them wrong a bit. I don’t want to be given a time and stick to it, I want to keep going because I have too many things and people that I want to engage with.


Do you still believe that the delay originally between the time you went to your own GP and the time when you finally got the colonoscopy did probably damage your chances of survival?


Well, the waiting period was seven months and seven months is a long time with cancer. I can’t prove it but I believe it, yes. I do believe it, because it had only just spread to my lungs, you know there are only a couple of spots on my lungs so it wasn’t that the cancer had completely invaded my body by that time, so yes, I believe the seven months was a disaster.


Do you feel in a sense the Irish health system let you down?


Yes, I do, I do. The fact that if I had VHI or any of the other private medical insurances, if I had them I would have been seen immediately and my chances of survival would have been better. The fact that there’s inequality built into the system means that I’m terminally ill. I believe that people should be seen on the basis of how ill they are, of their symptoms, not on how much money they have.


I know you think it’s important about the Kilkenny day centre that’s going to be set up, tell me about that and also there are other people who would argue there’s no point in having these smaller centres, you actually need these big centres of excellence if we’re ever going to treat cancer properly in Ireland.


People need hospitals in their communities, they don’t need to trek across the country when they’re ill to get the help that they need. This new centre will have 24 beds, it’ll be state of the art and it will cut down on the waiting lists because seven months is too long to wait for a colonoscopy when you’re bleeding from your rectum, when you’re bowl movements change rapidly. They tell you the symptoms and they tell you to hurry up and get seen but then they put you on a waiting list to get the diagnosis which doesn’t make sense but with this new unit hopefully that will put an end to it.


I sit before you and you’re incredibly brave and everybody worries about getting cancer and most Irish families have been touched by it. What is it like to have cancer, how do you cope with it?


You just take one day at a time. I wake up and I’m glad that I’m here, there’s a lot of good things to live for so every day that I have to spend with my husband and my children makes it worth it. It makes whatever you have to put up with cancer, you know there’s pain and it’s rotten, it’s horrible but I’m glad every morning I wake up it’s one more day I can spend with my family.


Are you frightened of what lies ahead or do you have great faith?


I’m not religious, no. I’m confident that I’ll have a comfortable death in the hospice here; they look after people very well. I want it to be as far away as possible but I’m confident I’ll be well looked after while I’m here.


If you had one message for the Irish health service and those who run it what might it be?


The health service should be for everyone equally, and that’s it. Everyone is entitled to a good health service; it shouldn’t depend on where you live or how much money you have in your back pocket. The health service is paid for by our tax money and so therefore we’re entitled to every service available that we need.

Playing volleyball with life

There was some interesting conversation on the Marian Finucane Show last Sunday about the latest shocking scandal concerning the gross incompetence in the treatment of breast cancer.

The panel consisted of Justine McCarthy (journalist), Liam Griffin, Joe Higgins (politician), John Crown (consultant) and Michael Colgan. At times it is difficult to identify who is speaking but here are some quotes to send a chill up the spine.

John Colgan:

“It’s interesting to listen to John Crown saying that it’s easy to make mistakes, and they’ll get suspended and they’ll get sacked and they’ll get changed. Yet, when Dr. Gupta wrote to the HSE, he was told, ‘go to the Dept. of Health’ and they sent him to the Medical Council, he was given the run around.

I come back to what Justine (McCarthy) said, 650 people are dying, 15% more than the EU average. People playing volleyball with this, not taking the blame, going home, saying they did nothing and actually killing people.”

John Crown: (I think)

“There are five or six really big places… that really try to do this right (for cancer patients).
But until O’Higgins identified all of this there were lots of little public hospitals where ego driven, cult personality run individual doctors were allowing breast cancer care to be done, I believe, inappropriately, incorrectly and to a lower than acceptable standard.”

Panel member: “How does that sound to somebody out there with breast cancer?”

Marian Finucane: Terrifying, I would have thought.

Panel member: “I’ll tell you something Marian, if anything goes wrong with me in this country, I’m glad I can afford it, I’m getting a second opinion and now when I read all of this, a third.”

Money,morality – Life,death

Consultant paediatrician and member of the National Immunisation Advisory Committee, Dr Kevin Connolly has criticised the delay in recommending whether the cervical cancer vaccine Gardasil should be provided under a National Immunisation programme.

The report (5th item) claims that the vaccine coupled with a screening programme could eradicate the disease within a generation.

You would imagine that there could be no objection to such a programme but as always the twin evils of social class and moral righteousness raise their ugly heads.

For those with the money our two tier health system will see their children safe from this deadly disease for a mere €600. Those who cannot afford the vaccine must wait until the Health Information and Quality Authority (HIQA) completes its cost-benefit analysis.

Already the mad mullahs in American and the UK have objected to the vaccine on the grounds that it might promote promiscuity among young girls. No doubt our own home grown religious mullahs are champing at the bit.

What these religious dinosaurs are essentially saying is;

We have no objection to rich people protecting themselves (because we are powerless to stop them) but we are prepared to risk the lives of less well off young women, by putting pressure on governments, in order to protect our moral sensitivities.

Mysterious disease to be replaced

I see the HSE has quietly dropped (Sub required) the infamous and very expensive PPARS computer system.

A combination of gross incompetence and greed saw costs rise from an initial €9 million to, a lot of heads should roll; €200 million.

Ah no, I’m only joking, no heads rolled at all.

Nobody knows who initiated the project, it was never established who was responsible for its rolling out and even today nobody knows who’s in charge. It was like a mysterious disease that swept through the Department of Health.

Never mind, that’s all behind us now and the HSE is buying another computer system but this time is refusing to tell us how much it’s going to cost.

Very clever strategy because, let’s say it costs, oh I don’t know, about €300 million, they can just say, yep, that’s what our experts estimated.

Secrecy protecting the system

Cover up, denial, secrecy, bureaucracy, non accountability, endangering life, corporate arrogance, corporate ruthlessness, political weakness, political cowardice

The above descriptions are just some of the obstacles that face Irish citizens on a daily basis when dealing with arrogant and self-serving bureaucracy in this corrupt state.

Rebecca O’Malley’s case is typical. She was told that a lump on her breast was benign but it turned out to be malignant. The error cost her 14 months in wasted time. She had to have a mastectomy which probably would not have been necessary if that time had not been wasted.

We are now told that the misdiagnosis was the result of “an interpretative human error”. Nobody will be held to account for this misdiagnosis. Neither will anybody be held to account for Mrs. O’Malley’s mental and physical suffering.

Concerned about the possibility that other women could be in danger, Mrs. O’Malley requested that the HSE carry out a review of recent cases. The first reaction of the HSE was to ignore her request and ‘encourage’ her to keep quiet.

This is a crucial point that we have to stop and think about. Somebody in the HSE decided that no action should be taken. Somebody decided that there was something of a higher importance than the health and possibly the lives of approximately 300 women.

Somebody decided that it was better to risk the health of these women rather than admit that an error had been made. That person/s should be named and shamed; he/she/they should be hounded from office and never again allowed to hold a position of responsibility. Because Ireland is a corrupt state, this will not happen.

Already, the usual strategies are being activated to protect the various interests. The first internal investigation is a whitewash, nobody has been held accountable.

Harney has now ordered another internal investigation which should get her over the election. This ‘investigation’ will also be a whitewash. We will get the usual waffle – ‘systems error’, ‘must never allow this to happen again’, ‘new procedures’, blah blah.

The person/s who decided to keep the original scandal a secret will still be there, in the system, protected by the system.

Secrecy and control – Breeding ground for corruption

The Irish Hospital Consultants Association (IHCA) is not an organisation I would normally find myself defending.

For far too long they have enjoyed a position of absolute power and privilege within the health system and so the Minister for Health, Mary Harney is right to insist on a new, more equitable, public contract with its members.

However, the insistence of a gagging clause in the new contract is just the latest example of an administration taking every opportunity to increase its powers of secrecy and control. Powers that are crucial for the manipulation of information in a corrupt state.

Here are some quotes taken from today’s Irish Times.

(Consultants) have to seek permission from new clinical directors before commenting in public on hospital services.

(Consultants) have to seek the approval of the clinical director before engaging personally in any further advocacy

…prevent consultants from divulging or discussing “hospital business” and information on staff or patients without authority except in the performance of their duty.

…that no-one else in the health service has the right to speak out publicly without official approval

Consultants’ traditional clinical autonomy will have to be circumscribed to a degree.

The aim here is to install a line of faceless unaccountable bureaucrats between doctors, and the general public in order to manipulate information about a third world health system rampant with corruption and incompetence.

Bizarrely, management is expected to claim that all this secrecy and control is for the patients own good, to protect them from rogue doctors like Michael Neary. The reality is, of course, that secrecy breeds corruption, incompetence and bad practice.

Telling it as it is

No one can doubt that the Irish health system is a total disaster with standards akin to the most corrupt of Third World countries.

Every once in a while, though, we witness a voice that has struggled in from the wilderness, a voice that tells it as it is, a voice we know that has only one agenda, the healing of sick people.

John Crown, consultant oncologist, writing in The Sunday Independent speaks in plain English about; Corruption, incompetence, dangerous medical practices, bullying, religious interference, rampant bureaucracy, turf wars and unnecessary deaths.

This article is well worth reading.