There was a time in this country, and not so very long ago, when a tightly-defined class of people was considered more trustworthy than the rest of us. If you needed to have some application form witnessed by a solid, dependable, upstanding rock of the community you went to one of those listed at the bottom of the sheet: Banker, Solicitor, Priest, Teacher, Doctor, Guard. And maybe one or two others that escape my memory right now.
A plumber wouldn’t do and neither would a carpenter. A mechanic was no good. You’d be wasting your time asking a plasterer, a bricklayer, a cook, or a footballer to vouch for you. No dressmakers wanted. No barbers on this list. No greengrocers, butchers, bakers or candlestick makers.
No gardeners. No nurses. No painters.
It was this simple: Banker, Solicitor, Priest, Teacher, Doctor, Guard. These were the professions considered reliable, weighty and above reproach by the officials who controlled our deferential little country and what a job they’ve made of it.
These days, you’d claim to be a human trafficker for ISIS before you’d admit in polite company that you’re a banker. The number of dodgy solicitors being rounded up on the beaches of Rio for extradition would keep a small airline in full-time operation. The clergy made such a monumental dog’s dinner of the sex-abuse scandals that they have lost the respect of all but the most fervent believers.
That list of witnesses on your application form is shrinking.
Today, as we speak, the antics of the Guards threaten to bring down the government with news emerging that the Justice minister was aware two years ago of a plan to soil the good name of an honest policeman, Maurice McCabe, in an effort to silence him. For all I know, the the Tánaiste might be gone before this edition hits the streets.
Strike the Guards out. One less witness to sign your form.
And then we have the doctors, or to be more specific, the consultants who, it turns out, are doing about a quarter of the work we pay them for while still taking the money.
The medical consultants, you see, as a specific term of their contracts, don’t have to submit to the same indignity as the rest of the work force by clocking in and out. Nobody counts their hours because they can’t be questioned.
Why? Well, you tell me. I don’t know.
There’s a specific provision written into law that public servants and civil servants with professional qualifications can’t work privately in their area of speciality. And this is why you can’t, for instance, walk into City Hall for a pre-planning meeting and arrange to be seen privately on payment of a fee.
There’s a good reason why this won’t happen: it’s illegal.
There’s a good reason it’s illegal: people are venal, greedy and corruptible.
We have had planning scandals in the past. We have had bribery and we have had corruption at the highest levels, as everyone knows. That’s why you won’t be brought to a City Hall design office and introduced to your personal architect and engineering team. Nobody will take your brief, carry out an architectural and structural design, draw up the plans of your mega-shopping-centre in a publicly-funded office, prepare the contracts and fast-track all the necessary approvals.
Yet that is precisely what most hospital consultants do. If you have the money, you can walk or hobble or crawl into a publicly-funded hospital, wave your cash at some personal secretary and within seconds you’ll be whisked past the shuffling hordes and rolled head-first into a publicly-funded MRI machine. You’ll have your results in your paw before the rest of them know if they’re even on the waiting list for the real waiting list. And if your case turns out to be urgent, you’ll glide past the queues on the stairs, into your publicly-funded bed to await your further treatment in a publicly-funded operating theatre, staffed by publicly-funded nurses and junior doctors, supported by radiologists and anaesthetists, all working for the benefit of your consultant. The one you’re paying because you can afford to.
Isn’t it nice?
As far as I know, we in this country pay as much for our healthcare system as anywhere else in Europe and yet we still end up with this mess.
Is it because we have so many layers of ineffectual administrators who prefer to call themselves managers? Is it because this useless administrative layer serves only to clog up the system?
Yes. That’s part of the problem but it’s not the entire explanation.
It drives me mad when I hear people saying they’re “under” some medical consultant. No, I want to tell them. You are under nobody. You have hired this person to fix you, just as you’d hire a mechanic to fix your car. Would you say you’re under your plumber or under your gardener unless you happen to be a fictional character in an unpublished DH Lawrence novel?
We need to look at the deep-seated culture of deference in this country, a dysfunctional attitude to authority with roots deep in our history. We need to start instilling in our young people a questioning attitude that refuses to accept the sort of nonsense that places medical consultants on a pinnacle where they are beyond questioning. We saw what this sort of attitude led to with the church scandals. We’re currently witnessing where it’s leading to with the Gardaí. And yet, it seems to me that the medical scandal is hiding in plain sight, so obvious nobody can see it. So unthinkable nobody can voice it.
An unchallenged cabal of well-heeled private business people dictates the shape of our national health system for their own private personal gain and we permit this situation to continue. We even reward them financially as it gets worse.
Let me add one caveat here: there are many fine, principled doctors who work far beyond their capacity to look after their patients, but as in all aspects of life, it takes just a few avaricious connivers to corrupt any group in society.
Right now, some consultants are making all doctors look dodgy and it needs to be stopped.
Otherwise the teachers are going to be busy signing all those application forms on their own.