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Health system a pressure cooker ready to blow

An Cailín Rua

An Cailín Rua
Anne-Marie Flynn

A decade after Ireland went from boom to bust, a new implosion is imminent. Unlike the sudden crash that blindsided so many in the noughties, the writing has been on the wall for our rickety health service for some time.
Fine Gael has been in government for almost a decade, and for that entire time the party has walked a tightrope. The history books will show – somewhat kindly – that it guided the country out of the doldrums, back to economic prosperity. This, however, was achieved by pushing non-wealthy people to the pins of their collars. And for years, the pressure cooker that is our utterly dysfunctional, money-eating health system has been heating up. Now the lid is about to blow.
The general practice (GP) system, cut to the bone and systematically under-resourced for years – it is allocated just 3.5 percent of the health budget – is on the verge of collapse, with the country suffering a chronic GP shortage. Like nurses, they too are under immense pressure, and in turn, hospitals are suffering.
Psychiatric nurses are implementing an overtime ban, due to lack of engagement on their recruitment and retention crisis. Some ambulance drivers are taking action due to a union-related dispute. Junior doctors are working in conditions that no human being should have to endure. The two-tier system, fostered for years, has made healthcare inaccessible to many.  
After deciding to take industrial action, nurses now face a battle to retain public support, in the face of a push-back campaign in some national media that implies that the nurses are being selfish, driven by greed, and indifferent to the needs of patients. Of course, most people with reason to pass through a hospital recently will be aware of the reality; the cancellation of non-urgent procedures that is making headlines has been a problem for years. Stressed, fearful, under-resourced and burnt out, our nurses are fully justified in their stance. The public knows it, and the Government, beyond a shadow of a doubt, knows it too.
Let’s talk about the regular reference to nursing or medical practice as a ‘vocation’. That may be, but it is also a job. Nurses, in particular, are elevated to a status close to sainthood that has the effect of – almost subliminally – holding them to a higher moral standard (particularly among people who earn more than them) that implies they should somehow be satisfied by knowing they are doing good, and should not expect or demand adequate remuneration. Nonsense.
Not every nurse is a saintly Florence Nightingale. Not every nurse gets everything right all the time, nor should they be expected to. Nurses are not saints. They are human beings, with bills to pay and families to feed, susceptible to bad days as well as good, and allowed to get angry or demotivated when they are disrespected, their work is not properly compensated, their worth is not recognised, their working conditions are substandard. It is a testament to their patience that they did not reach breaking point years ago, and a shame their unions allowed it to go so far.
Removing emotion from the situation, it is hard not to have some sympathy for Paschal Donohoe and Simon Harris. It is difficult to balance public finances and maintain industrial peace. The timing is particularly unfortunate, with Brexit looming, but the health service was in crisis long before David Cameron pulled the pin, and successive governments failed to address it. Now they are reaping what has been sown for decades – the seeds of cowardice. Naturally, sympathy is scant for a government that has presided over so much wastage, instigated so little reform and consistently shown disdain for those less well off.
Fixing this mess will take courage and hard decisions and may bring a storm down upon this government that it must have been praying would never materialise. But nurses are not the same as pen-pushers or politicians. One size does not fit all. They should never have been treated thus, nor allowed themselves to be.
Ultimately, public pressure will force the Government’s hand; it will have little choice but to engage. Public opinion – hardly unreasonably – is that patients deserve to know that they are safe in our hospitals. Our nurses, too, deserve that much at least.