Is fearr an tsláinte ná na táinte

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My early years are replete with memories of the wisdom contained within the Irish seanfhocal. My mother, a fluent Irish speaker, enjoyed nothing more than a good natter as Gaeilge with a seanfhocal at her fingertips for every eventuality. A particular favourite, whenever a cold or any other ailment made its appearance, was ‘Is fearr an tsláinte ná na táinte’ (Health is better than Wealth).

Throughout my travels since, this seanfhocal has remained at the forefront of my mind. How could one argue with the fact that without health, wealth contains within it no more than an empty promise of happiness? Sadly, personal experience has led me to the realisation that for many, particularly when it involves the health of others, this seanfhocal is anything but an evident truth.

No better example of this exists than our Minister for Health Mary Harney. Animated by a rigid and inflexible conviction in the merits of the free market, Harney á la Thatcher’s notorious dictum “There is no alternative”, has overseen the degradation of the Irish public health service during a time of unparalleled economic bliss. Undeterred, some would even argue ‘boosted’, by the recession raging around us, Harney merrily continues on her crusade to dismantle the public health service limb by limb. Given her mandate as the Minister for Health, this has translated into a reduction of the public health sector to as great an extent as the political climate will allow while concomitantly facilitating the increasing role of the private sector.

The results of this ideology can be seen in the closing down of services, particularly in more rural-located hospitals and their subsequent centralisation in larger urban areas. A flagrant example has been the closing of numerous cancer units in order to concentrate cancer treatment in eight purported centres of excellence. While for many this might appear to be a logical process, their success is surely called into question by the fact that certain of these centres are keeping patients waiting up to a year for treatment. Even more to the point, the amount of time patients have to spend travelling to and from centres located hours from where they live can hardly be beneficial to their recovery. Alternatively, the economic and emotional costs of living far from home in order to access critical treatment can drain the very ‘life blood’ of patients in more ways than one.

For people who are seriously ill, the argument that their condition is not a priority, must seem like an evil joke, given the examples of flagrant waste that continue to be drip fed to the media. Indeed, stories of HSE profligacy are legion. In July this year it was revealed that a €1.5 million scanner had lain idle for a year after its purchase at Mallow General Hospital (MGH) and how public patients were being sent at a cost of €6,000 a week to the Bon Secours private hospital for treatment. In February 2008 we learnt how a completely-fitted building donated to the HSE West in Inverin still lay vacant, at the same time as bed shortages obliged numerous patients in University Hospital Galway to lie stranded on trolleys throughout its corridors.

Last May we were informed that health executives and government officials admitted an error in the new hospital consultants’ contract meant €50m would have to be found for the hospital fees of patients who would in the past have been covered by their own health insurance. To add insult to injury, the public sector, the target of fierce attacks regarding its spending, effectively subsidised private insurance companies to the tune of €167 through its failure to charge 180,000 private patients who had been accommodated in public wards in 2008.

It is hard to go through a single week without at least one more example of egregious waste being uncovered. Indeed, so many examples have come to light that in a perverse manner they almost act as a kind of protective shield, as the HSE’s reputation has become so encrusted in incompetence that criticism just tends to bounce of its scales.

However, this is to miss the point. These failures are of scant concern to Harney, who effectively shields herself behind a battery of public relations officials and will most likely not be subjected to any public accountability at the ballot box. As the Comptroller and Auditor General, John Buckley, cogently pointed out:

“The low rate of income recovery from patients who were treated privately in the hospitals reviewed would suggest that the State is facilitating private medicine without getting the related income for the service it provides.”

Buckley has put his finger on the crux of the matter. As Sara Burke, author of Irish Apartheid – Healthcare Inequality in Ireland has written:

“At its most benign, this increased, unplanned, unregulated privatisation of healthcare can be considered hugely irresponsible of our political leaders. At its most insidious, it could be considered sabotage of the very public health system they are meant to lead.”

While many complain that Harney has failed the Irish public health service, in her own eyes, she would probably regard her reign as a highly successful one. It is just that she does not judge herself using the same criteria as the majority of the Irish population.

As the ‘People Doctor’ argued in the Kilkenny People in March 2006:

“Health care is about health care. It is not about economics. If we allow our economic views to dictate our health system, then people will suffer. Just like in the US, where the “best” system of health management, does not provide the “best” care for the people.”

The People Doctor then went on to express his hope that should Harney take a private trip to Washington with an open mind, she might possibly realise how the “American Dream has failed its people on health.”

However, this is unfortunately just a pipe dream as our Minister for Health quite clearly regards whether or not the American Health system works in the way we think it should, as an irrelevancy. For Harney, my mother’s favourite seanfhocal too is an anachronism, as she rewrites the wisdom of our past to read “Is fearr na táinte priobháideacha ná sláinte an phobail” (Private Wealth is better than Public Health).

Photo of the lobby of The Galway Clinic courtesy of